The Psycho Analytical Treatment Of Children

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THE

TREATMENT OF CHILDREN

THE PSYCHO-ANfAtYTlGAL
TREATMENT OF CHILDREN

Technical Lectures and Essays

by
ANNA FREUD

Part I and II translated from the German
by NANCY PROCTER-GREGG

JMAGO PUBLISHING CO, LTD,
LONDON

in this form 1946

PRINTED IN GREAT BRITAIN BY THE CHISWICK PRESS, NEW SOUTHGATE

LONDON, N.I I

Translator's Note

For members of the teaching profession and parents who may have no par-
ticular knowledge of psycho-analysis and its terminology, I venture to proffer
here some very rough-and-ready explanations of the more technical terms,
which are naturally used without elucidation in lectures addressed directly to
practising analysts, but which might prove a stumbling block to a wider circle of
readers.

It will be appreciated that such explanations are strictly ad hoc , directed merely
to the purpose of making this book more intelligible to the lay reader. No
criticism of the conceptions embodied in the terms explained can justly- be
founded on them; . brief notes of this kind upon the terminology of a young
science cannot be framed in such a way as to stand examination directed to the
premises of the science itself.

I assume that the conception of "the unconscious" is nowadays fairly clear to
most people. It is that highly active self within us of winch ex hypotkesi we are
not directly aware. We are, of course, always aware of some (not all) of its acti-
vities, even in sleep, when we dream. Repression is the process applied to im-
pulses, notions, etc. unwelcome to our conscious selves, which we mean to, but
cannot, discard; repression throws them, not into the discard (as we may have
supposed until the analytical undoing of repression in the treatment of some con-
sequential neurosis leads to their reappearance), but into the unconscious.
Repression in this technical sense, i.e. "making unconscious," is naturally itself an
unconscious process (though the movement towards rejection may not have been)
and permits no memory of the occasion.

The Id, the Ego and the Super- Ego are terms which to be properly understood,
so far as understanding yet goes, require at least a book to themselves. They
may very broadly be thought of, for the purpose of understanding these lectures,
as respectively the unconscious, the conscious, and the "conscience" functions of
the self. Both Ego and Super-ego dip deep into the unconscious, and should not
be thought of as by any means entirely accessible to awareness. It is part of the
theory of the super-ego that it is the internal judge of the self, which has deve-
loped, largely unconsciously, from the "internalisation" of requirements and
ideals to which the self at some period has given allegiance: usually those adum-
brated by the parents, whether consciously or merely in the child's often dis-
torting imagination.

The "transference" is the very definite emotional attitude assumed by the
patient, under the direction of his unconscious, in analysis towards the analyst;

.TRANSLATOR s

atfisjng, vesy.- rptT^lly:&pfealtiRg" From the fact that the analyst who re-elicits re-
pressed reaqtigns^Jbecomes the representative of what originally occasioned either
them or ttceityi^ession.

The meaning of the other technical terms used will probably be deduced from
their nomenclature or context. "Compulsion neurosis" is of course the common
kind of mental maladjustment which so often takes a mild form in people who
feel they cannot (or must) step on the cracks in the pavement. The latency period
is that beginning usually about the fifth year of a child's life and lasting until
' puberty; the child's early active and highly varied sexual impulses, connected
with the various "erogenous zones" of the body affording gratification (ranging
from the pleasures of sucking to those of anal activity, onanism etc.), become
largely latent; the energy supplying them is to a great extent diverted.

The Oedipus complex, to which so many sinister allusions are made by those
who do not trouble or do not like to inform themselves of what they are talking
about, is merely a handy, almost algebraical, way of denoting the whole set of
feelings attached to the natural impulse of all children to crave for exclusive love,
usually from the parent of the opposite sex. The myth of Oedipus, who un-
knowingly carried the fulfilment of this instinct to its extreme, by killing his father
and marrying his mother, stands conveniently for the whole complex of this wish,
and its derivatives; which may (like any other desire which the individual may be
unable to handle satisfactorily) lead to unhappy consequences when repressed
into the unconscious.

As for the function of analysis itself, a brilliant short exposition will be found
in the fourth lecture (p. 38), in a passage which may be read with p*fefit before
the book is begun.

Table of Contents

PAGE

PREFACE

PART i: INTRODUCTION TO THE TECHNIQUE OF THE

ANALYSIS OF CHILDREN (1926) 3

First Lecture: An Introductory Phase in the Analysis
of Children..

Second Lecture: The Methods of Children's An-
alysis.

Third Lecture: The Role of Transference in the
Analysis of Children.

Fourth Lecture : The Analysis of Children and their
Upbringing.

PART II : THE THEORY OF CHILDREN'S ANALYSIS (1927) $ $

PART III: INDICATIONS FOR CHILD ANALYSIS (1945) 6j

BIBLIOGRAPHY 95

Preface

Part I of this series comprises a course of lectures given in 1926 before
the Vienna Institute of Psycho-Analysis under the title Introduction to
the Technique of the Psycho- Analysis of Children (i). Part II, which
slightly amplifies the subject matter treated in this introductory series
of lectures, was, soon afterwards, read as a paper, at the Tenth Inter-
national Psycho- Analytical Congress in Innsbruck, 1927 (2). Part III
was written for The Psychoanalytic Study of the Child^ 1 945 (3), and
attempts to summarise some of the advances in the understanding and
evaluation of the infantile neurosis which the author has made in the
intervening nineteen years of work on the subject.

The audience of the first five lectures was, in each instance, composed
of practising and prospective analysts, and accordingly both subject and
phraseology of the main part of the book are technical.

It is not the author's fault that the early material contained in this
publication is presented to the English reader at such a late date. An
English version of the Introduction to the Technique of Child- Analysis (4)
was, published in America. Attempts at publication in England were
not successful. For the general publisher the subject matter was still too
remote and controversial. Professional psycho-analytical circles in
England, on the other hand, were at that time concentrating their interest
on Mrs. Melanie Klein's new theory and technique of the analysis of
children (5). The British Psycho- Analytical Society devoted a Symposion
on Child- Analysis (6) to a severe criticism of the author's efforts^ which
ran counter to Mrs. Klein's outlook. The Introduction to the Technique
of the Analysis of Children was rejected when offered to The Inter-
national Psycho-Analytical Library for publication, and the matter
lapsed, so far as England was concerned.

In Vienna, from 1927 onward, a group of analysts, later joined by
colleagues from Budapest and Prague, held regular meetings with the
author to discuss the technique of the analysis of children, as it emerged
from these introductory lectures, to report on cases which were treated
with this method, to compare results, and to clarify the theoretical back-
ground of the practical findings. The age range to which the technique

was found applicable was lowered from the latency period, as originally
suggested, to two years, and extended at the other end to pre-adolescence
and adolescence. All types of non-organic disturbances of childhood
development were taken into treatment, from the usual phobias, hysterical
illnesses, obsessional disturbances, bed-wetting, stammering, compulsive
masturbation and exhibitionism, neurotic constipation, to grave abnormal-
ities of a schizophrenic type (7-30). Analyses of delinquent children were
attempted and carried out, in close co-operation with the work of August
Aichhorn on juvenile delinquency which was developed and taught by
him in Vienna at the same time (31-34).

Before these developments in the field of analytical therapy for children,
Vienna had already been a fertile ground for the psycho-analytical study
of normal child development, and for the application of this new know-
ledge to education. Students of the subject had for years been listening to
the inspiring lectures for teachers and youth leaders given by Siegfried
Bernfeld (39-42), and many young and enthusiastic workers had taken
part in his experiment in education in "Kinderheim Baumgarten", a
camp school for homeless children which formed part of the American
relief work for children in the post-war period after 1918. In 1929 the
author was commissioned by the School Inspectorate of the City of
Vienna to give four lectures on psycho-analysis to the teachers of the
Children's Centres of the City (50). This marked a further step in the
co-operation between psycho-analysis and education, which from then
onward developed freely in all its branches. Some members of the Vienna
Institute of Psycho- Analysis devoted a fair share of their teaching and
lecturing activity to consolidating the, ground which had been gained.
The Vienna Psycho-Analytic Society thus (besides training for the
therapeutic analysis of neurotic and delinquent children) sponsored one
Child Guidance Clinic for young children (directed by Edith Sterba),
one Child Guidance Clinic for adolescents (directed by August Aichhorn) 5
special discussion groups for teachers of the City who dealt with problem
children in their own classrooms ; and, organised by Dr. W. Hoffer, a
three years post graduate Training Course for teachers who received
instruction in psycho-analytical child psychology, and guidance in its appli-
cation to their handling of children (35-38, 43-68). To these ventures was
added in 1937 an experimental Day-Nursery for infants between one
and two years of age, which was founded and maintained by Dr. Edith
Jackson, New Haven, and organised by the author in conjunction with
Mrs. Dorothy Burlingham, and with themedical help of Dr. Josefine Stross.

PREFACE XI

So far as Vienna was concerned, these activities ended with the political
changes in 1938. Nearly all the participants in the work left Austria, to
continue elsewhere. Both sides of the work, the therapeutic as well as the
one applied to education, were pursued further in the new surroundings.
Members of the former Vienna Seminars for Children's Analysis joined
up, in Holland or America, with other analytic colleagues to form similar
seminars and discussion groups, or, as in England, continued the work
among themselves. Analytic Child Study and work with educators was
welcomed in all countries, for in the meantime interest in the problems
of upbringing of normal and abnormal children had gradually Increased.
Experimental Nurseries based on analytic principles came into being in
Boston, Detroit and Los Angeles. The organisers of the Vienna Nursery,
now in London founded and directed the so-called Hampstead Nurseries
(69, 70), a Residential War Nursery, financed by the Foster Parents' Plan
for War Children, Inc., New York, to which a three years' theoretical
and practical Training Course for Children's Nurses and Teachers was
attached.

The extensive work done in psycho-analysis applied to education had
in time its welcome repercussions on the therapeutic analysis of children,
and led to important modifications on the technical side. In 1926, before
there was any systematic teaching of either parents, teachers, or children's
nurses, the author was justified in saying that the children's analyst must
"claim for himself liberty to guide the child ..." (p. 45) and "accordingly
combine in his own person two difficult and diametrically opposed func-
tions: he has to analyse and educate, . . ." (p. 49). In 1946, after twenty
years of intervening work with educators, such a statement is no longer
legitimate. The children's analyst now shares his knowledge of the child's
requirements with the workers in the field of education and upbringing,
and accordingly his task has become easier. Whereas formerly he himself
had to assume the "position of authority" (p. 45), he can now, with
rare exceptions, concentrate his energies on the purely analytic side of
the task, and count on the co-operation of enlightened parents, school
teachers or nurses to supply the intelligent control and guidance of the
child which are the indispensable accompaniment and counterpart of its
analysis.

For reasons of another kind, certain statements made in the First
Lecture on An Introductory Phase in the Analysis of Children^ must be
modified in the light of modern developments. In a study of the defence
mechanisms of the ego (7), the author described ways and means to

Xll PREFACE

uncover and penetrate the first resistances in the analysis of children,
whereby the introductory phase of the treatment is shortened and., in
some instances, rendered unnecessary. Berta Bornstein, in a recent
publication (7 2), gives a useful and well illustrated account of the technical
changes in the analysis of children which arise from the study of their
various defence mechanisms.

The Second Lecture does not require similar modifications. The
author's views on The Methods of Children's Analysis have to a large
degree remained unchanged.

The opinions expressed in the Third Lecture, on The Role of Trans-
ference in the Analysis of Children^ have during the last twenty years been
repeatedly opposed by children's analysts in England and America who
maintain that the children under their treatment show profuse signs of
transference which is open to analysis in the same manner as in the
analysis of adult patients. The author fully agrees that this is the case.
But, in spite of these manifold and variegated transferred reactions of the
child, the author has not, so far, met a single case of a child patient where
the original neurosis was given up during the treatment and replaced by
a new neurotic formation in which the original objects had disappeared
and the analyst taken their place in the patient's emotional life. It is only
a structure of this kind which deserves the name of transference neurosis.
So far as the author's experience goes, the letter occurs solely in cases of
adult neurotics who are treated with the classical technique applicable
only to patients who have reached maturity,

PART I

Introduction

to the' Technique of

the Analysis of Children

(1926)

FIRST LECTURE
An Introductory Phase in the Analysis of Children

Ladies and Gentlemen. It is difficult to assert anything about
the technique of the analysis of children without first making
clear one's position on the question : in which cases would one
in general consider that an analysis should be undertaken, and
in which would it be better to refrain?

Mrs. Melanie Klein has as you know fully considered this
question in her publications and in her lectures. She takes the
view that any disturbance in the intellectual or other psycho-
logical development of a child can be resolved or at least favour-
ably influenced by an analysis. She goes still further, and main-
tains that an analysis is of the greatest benefit also to the deve-
lopment of a normal child, and in the fulness of time will become
indispensable to complete all modern education. On the other
hand, it transpired in the course of a discussion at one of
our meetings last year that the majority of our Viennese
analysts take a different point of view, and maintain that the
analysis of a child is only appropriate in the case of an infantile
neurosis.

I am afraid that I am not going to be able to contribute much
in the course of these lectures to the elucidation of this question.
The most I can do is to give you an account of what cases I did
undertake to analyse, and say in which of them this decision
proved justified and in which the analysis came to grief owing
to internal or external difficulties. It is natural that when one
comes to make fresh decisions one is encouraged by a recent
success and apt to be deterred by a failure. On the whole, I think
one sometimes gets the impression in working with children
that analysis is here a method too difficult, costly and com-
plicated, that one does too much with it; contrariwise, in other
cases, and that still more often, one feels that with pure analysis
one accomplishes much too little,

4 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

It may thus happen that analysis, where children are con-
cerned, requires special modifications and adjustments, or
indeed can only be undertaken subject to certain precautions.
Where then the introduction of these precautions is impractic-
able, the carrying out of an analysis may be inadvisable.

In the course of these lectures you will see from manifold
examples the application of the foregoing remarks. I shall on
purpose leave for the present on one side any attempt to take
this question further, and shall concern myself with the tech-
nical process of the analysis of children in those cases where for
some reason, which for the moment we shall not go into, it seems
advisable to undertake that treatment.

In the last year I have several times been invited to give a
report of an analysis of a child at one of the technical courses of
our Society, and to examine in that connection the special tech-
nique of the analysis of children. Up to now I have always de-
clined this request, for I was afraid that anything that one could
say oh this subject must seem to you banal and obvious. The
special technique of the analysis of children, in so far as it is
special at all, derives from one very simple fact: that the adult
is at least to a considerable degree a mature and independent
being, while the child is immature and not self-dependent It is
evident that to deal with such different subjects the method
cannot remain uniform. Many of its elements, important and
significant "in an adult case, lose their importance in the new
situation ; the rdles of various expedients are shifted, and what
was there a necessary and innocuous procedure becomes here
perhaps risky. Such modifications however occur to everyone
according to circumstances, and hardly require a special
theoretical foundation.

In the last two and a half years however I have had the oppor-
tunity to conduct ten long analyses of children, and I shall try
in what follows to arrange the observations which I was enabled
to make in the way in which they would probably have im-
pressed anyone amongst you under equally favourable cir-
cumstances.

We shall accordingly keep to the actual sequence of events
as they occur in an analysis, and begin with the attitude of the
child at the outset of the analytical work,

AN INTRODUCTORY PHASE

Let us consider first the analogous situation with an adult
patient. A person feels that he is disturbed, in his work or his
enjoyment of life, by some sort of difficulty within himself; he
gains on one ground or another, confidence in the therapeutical
power of analysis or of some particular analyst; and he makes
the decision to seek a remedy by this means. I know of course
that the facts are not always altogether like this. It is not always
exclusively the inner difficulties which are the motive for the
analysis frequently this is only provided by the conflicts with
environment which arise from them. Again, the decision is not
always made really independently; pressure from relatives or
others often plays a rdle greater than is favourable for the later
progress of the work. Nor is confidence in analysis and the
analyst always a factor. But still it always remains for the treat-
ment the wished-for and ideal situation, that the patient should
of his own free will ally himself with the analyst against a part
of his inward being.

This state of things is naturally never to be found amongst
children. The decision for analysis never comes from the child
who is to be the patient, but always from the parents or other
persons round it. The child is not asked for its consent. If the
question were put to it, it couldjiardly pronounce an opinion or
find an answer. The analyst is a stranger, analysis itself some-
thing unknown.

But what constitutes an even greater difficulty is that in
many cases the child itself is not the sufferer, for it often does not
perceive the trouble in itself at all; only the persons round it
suffer from its symptoms or outbreaks of naughtiness. And so
the situation lacks everything which seems indispensable in the
case of the adult: insight into the malady, voluntary decision,
and the will towards cure.

This does not impress every analyst of children 'as a serious
obstacle. You will be aware from Mrs. Melanie Klein's writings
how she comes to terms with these circumstances and what
technique she founds on them. To me, on the contrary, it seems
that one ought to try whether one cannot produce in the child's
case, too, the situatipn which has proved so favourable in the
adult's, that- is to say, whether one cannot induce in the child in
$ome way the missing readiness and willingness,

6 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

I shall make it the subject of my first lecture to show you how
in six different cases, of ages between six and eleven, I succeeded
in making the small patient "analysable" in the sense of the
adult, that is to say inducing an insight into the trouble, im-
parting confidence in the analyst, and turning the decision for
analysis from one taken by others into its own. Children's
analysis requires for this task a preparatory period which does
not occur with adults. I must emphasize that everything which
we undertake in this period has nothing to do with the real
analytical work, that is to say there is as yet no question
of making unconscious processes conscious or of analytical
influence on the patient. It is simply a matter of converting an
unsuitable situation into a desirable one, by all the means which
are at the disposal of an adult dealing with a child. This time
of preparation the "dressage" for analysis one might properly
call it will last the longer, the further the original condition
of the child is from that of the ideal adult patient which has
already been described.

Such a task need not moreover always be very difficult; the
step which has to be taken is often not a specially big one. I am
reminded of the case of a little six-year-old girl who was sent to
me last year for three weeks* observation. I had to determine
whether the difficult, silent and unpleasing nature of the child
was due to a defective disposition and unsatisfactory intellectual
development, or whether we had here a case of an especially
inhibited and dreamy child. Closer observation revealed the
presence of a compulsion neurosis, unusually severe and well-
defined for such an early age, together with acute intelligence
and keen logical powers. In this case the introductory process
proved very simple. The little girl' already knew two children
who were being analysed by me, and she came the first time to
the appointment with her slightly older friend. I said nothing
special to her, and merely left her to gain a little confidence in
the strange surroundings. The next time, when I had her alone,
I made the first attack. I said that she knew quite well why her
two friends came to me, one because he could never tell the
truth and wanted to give up this habit, and the other because
she cried so often and was angry with herself for doing so; and
I wondered whether she too had been sent to me for some such

AN INTRODUCTORY PHASfi 7

reason. At that she said quite frankly "I have a devil in me.
Can it be taken out?"

I was for a moment taken aback at this unexpected answer.
Certainly it could, I said, but it would be no light work. And if
I were to try with her to do it, she would have to do a lot of things
which she would not find at all agreeable. (I meant of course
that she would have to tell me everything).

She had a moment or two of earnest meditation, then she
replied ,"If you tell me that it is the only way to do it, and to
do it quickly, then I shall do it that way/' Thereby of her own
free will she bound herself by the essential rule of analysis. We
ask nothing more of an adult patient at the outset. But further,
she fully understood the question of the length of time neces-
sary. When the three trial weeks were up her" parents were
undecided whether to leave her under analysis with me or to
put her under other care. She herself however was very dis-
quieted, not wanting to give up the hope awakened while with
me that she would be cured, and kept insistently demanding
that if she had to go I should rid her of her devil in the three or
four days remaining. I assured her that this was impossible and
that it would take a long time of working together. I could not
make this intelligible to her with numbers, for although she was
already of school age, on account of her numerous inhibitions
she had as yet no knowledge of arithmetic. Thereupon she sat
herself down on the floor, pointed at the pattern of my carpet,
and said,"Will it take as many days as there are red bits? Or
even as many as the green bits?" I showed her the great number
of appointments that would be necessary by referring to the
many medallions in the pattern. She fully grasped the point,
and in the imminent decision did her part in persuading her
parents of the necessity for a very long time of working with me.

You may say that in this case it was the gravity of the neurosis
which lightened the work of the analyst. But I think that would
be a mistake. I will give you an example of another case in which
the introductory phase took a similar course, although there
could have been no question of a real neurosis at all.

About two and a half years ago I made the analytical ac-
quaintance of a difficult little girl of nearly eleven. She was
from the well-to-do Viennese middle-class, but the relationships

8 THE PSYCHO-ANALYTICAL TREATMENT, OF CHILDREN

in her home were unfavourable, for her father was weak and
little concerned with her, the mother had been dead for some
years, and her relationship with the father's second wife and a
younger step-brother was unsatisfactory. A number of thefts
by the child, and an unending series of crude lies and small and
great concealments and insincerities had determined the step-
mother, on the advice of the family physician, to seek the aid
of analysis. Here the analytical treaty was equally simple,
"Your parents cannot do anything with you," was the 'basis of
the negotiations, "with their help alone you will never get out
of the constant scenes and conflicts. Perhaps you will try the
help of a stranger/' She accepted me without more ado as an
ally against her parents, just as the little compulsion-neurotic
I described before did against her devil. The insight into the
malady of the compulsion-neurotic was here clearly replaced
by insight into the conflict; the factor actually common to both
however was the amount of suffering, which in the first case
sprang from inward causes and in the second from outer.

My next procedure in this second case was throughout that
recommended by Aichhorn for the educational treatment of
delinquent children. The probation officer entrusted with the
case of such children, says Aichhorn, must first of all put him-
self on the side of the delinquent, and assume that the child is
justified in its attitude to those about it. Only so will he succeed
in working with his charge instead of against him. I might
emphasize here that Aichhorn's position for this kind of work
has considerable advantage over that of the Analyst. He is
authorised to interfere by the state or town, and he has behind
him the authority of an official position. The analyst on the
contrary, as the child knows, is commissioned and perhaps paid
by the parents, and he always gets into an awkward position if
he sets himself against his clients, even if it is in their own
interest. In fact I never held the necessary consultations with
this child's parents without feeling uneasy, and the analysis
after some weeks, in spite of the best inherent conditions,
finally came to grief on account of this unclarified relationship.

In these two cases at all events the preliminaries necessary
for the beginning of a real analysis, the sense of suffering, con-
fidence in analysis and decision in favour of it, were created

AN INTRODUCTORY PHASE y

with little trouble. Let us now go to the other extreme, and
consider a case in which none of these three factors was present.

This was a ten-year-old boy with an obscure mixture of many
anxieties, nervous states, insincerities and childish perverse
habits,. Various small and one more serious theft had occurred
in recent years. The conflict with his home surroundings was
no open and conscious one, and on the surface any insight into
his very uncomfortable condition, or any wish to change it, was
not to be found. His attitude to me was one of thorough-going
rejection and mistrust, his whole endeavour being directed to
protecting his sexual secrets'from discovery. Here I could not
employ either of the two expedients which had proved feasible
in the other two cases. I could neither ally myself with his
conscious Ego against a split-off part of his nature (for he felt
nothing of such a division), nor offer myself as a partner against
his surroundings, to which so far as he was consciously aware
he was attached by the strongest feelings. I clearly had to take
another course, more difficult and less direct, for it was a
question of creeping into a confidence which was not to be won
directly, and forcing myself upon a person who was of the
opinion that he could do very well without me.

I tried to do this in various ways. At first, for a long time, I
did nothing but follow his moods and humours along all their
paths and bypaths. Did he come to his appointment in a
cheerful disposition, I was cheerful too; if he were serious or
depressed, I was the same. Did he prefer, instead of moving
about or sitting or lying down, to spend the hour under the
table, I would treat it as the most natural thing in the world and
hold up the tablecloth and speak to him under it. If he came
with string in. his pocket, and began to show me remarkable
knots and tricks, I would let him see that I could make more
complicated knots and do more remarkable tricks. If he made
faces, I pulled better ones, and if he challenged me to trials of
strength I showed myself incomparably stronger. But I fol-
lowed his lead in every subject of talk, from tales of pirates and
questions of geography to stamp-collections and love stories.
In these conversations nothing was too grown-up or too delicate
a subject for me to talk to him about, and not even his mistrust-
fulness could suspect an educational intention behind what I

IO THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

said. My way was rather like that of a film or novel which has no
other intention than to attract the audience or reader to itself, and
with this aim concentrates on the interests and needs of its
public. My first aim was in fact nothing else but to make myself
interesting to the boy. That in this first period I became
familiar at the same time with many of his interests and inclina-
tions which lay near the surface was an accessory advantage.

After a time I brought in another factor. I proved myself
useful to him in small ways, wrote letters for him on the type-
writer during his visits, was ready to help him with the writing
down of his daydreams and self-invented stories of which he
was proud, and made all sorts of little things for him during his
hour with me. In the case of a little girl who was undergoing
her preparation at the same time I zealously crochetted and
knitted during her appointments, and gradually clothed all
her dolls and teddy bears.

To put it briefly, I developed in this way a second agreeable
quality I was not only interesting, I had become useful. As
an accessory gain in this second period I had by means of the
letter and story writing obtained an introduction into the sphere
of his acquaintance and his fantasies.

Then however came something incomparably more impor-
tant. I made him notice that being analysed has very great
practical advantages, that for example punishable deeds have an
altogether different and much more fortunate result when they
are first told to the analyst, and only through him to those in
charge of the child. And thus he got the habit of relying on
analysis as a protection from punishment and claiming my
help for repairing the consequences of his rash acts; he let me
restore stolen money in his place and got me to .make all neces-
sary but disagreable confessions to his parents. He tested my
abilities in this direction over and over again before he decided
really to believe in them. After that however there were no
more doubts ; besides an interesting and useful companion I had
become a very powerful person, without whose help he could
no longer get along. Thus in these three capacities I had made
myself indispensable to him. He was now in full dependence
and in a transference relationship. I had however only waited
for this moment to require of him in return not in terms and

AN INTRODUCTORY PHASE ti

not all at one stroke very energetic and comprehensive co-
operation; namely the surrender,, so necessary for analysis, of
all his previously guarded secrets, which then took up the next
weeks and months and with which the real analysis first began.

You observe that in this case I concerned myself not at all
with the establishment of insight into the malady, which in
later progress came of itself in quite a different way; here the
problem was only the creation of a tie between us, which must
be strong enough to sustain the later analysis.

But I fear from this detailed description you may think that
there was nothing at stake but this tie. I will try to reduce this
impression with the help of other examples which hold a middle
course between the two extremes I have mentioned.

I was called upon to analyse another ten-year-old boy, who
had recently developed a symptom which was very unpleasant
and disturbing to those about him, namely noisy outbursts of
rage and naughtiness, which broke out for no intelligible out-
ward reason and were very strange in this otherwise inhibited
and timid child. It was easy in this case to gain his confidence,
for I was already known to him. The decision for analysis har-
monised too with his own intentions^ for his younger sister was
already my patient, and jealousy of the advantages of her
position in the family which she clearly derived from this fact
made his wishes turn in the same direction. In spite of this I
found no direct point of attack for the analysis; but the explana-
tion was not far to seek. He had indeed so far as his anxiety was
concerned a partial insight into the malady, and a certain desire
to get rid of it and of his inhibitions. But for his main symptom,
the rages, it was rather the contrary, Of them he was unmistak-
ably proud, regarding them as something which distinguished
him from others (if indeed not directlyin afavourablesense), and
he enj oyed the worry they caused his parents. He thus felt himself
in a certain sense at one with this symptom, and would probably
at that time have resisted any attempt to rid him of it with
analytical help. But here I ambushed him in a not very honest
way, I resolved to embroil him with that part of his nature, I
made him describe the outbreaks as often as they came and
showed myself concerned and thoughtful. I enquired how far
in such states he was yet master of his action at all, and compared

12 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

his fits of rage to those of a madman who would be beyond my
aid. At that he was startled and rather frightened, for to be re-
garded as mad naturally did not chime with his ambitions. He
now tried himself to master these outbreaks, began to resist
them instead of as earlier to encourage them ; thereby he noticed
his real lack of strength to suppress them and so felt an enhance-
ment of his feelings of suffering and discomfort. After a few vain
attempts the symptom finally, as I had intended, turned from a
treasured possession into a disturbing foreign body,, to fight
which he only too readily claimed my help.

It will strike you that in this case I induced a condition which
had been present from the beginning in the little compulsion-
neurotic ; a split in the child's inner being. In yet another case,
of a seven-year-old neurotically naughty little girl, I determined
on the same artifice at the end of a long preparatory period
similar to those already described. I suddenly separated offall her
naughtiness and personified it before her, giving it a name of its
own and confronting her with it, and even tually succeeded i n s o far
that she began to complain of the person thus newly created by
me, and obtained an insight into the amount of suffering she had
endured from it. The "analysability" of the child came hand in
hand with the insight into the malady established in this way.

But we must not forget another limitation. I once analysed
an unusually gifted and sensitive little girl who cried too easily.
She wanted very much to get over this tendency with the help
of analysis. But the work with me always stuck at a certain stage,
and I was on the point of contenting myself with a minor
amelioration. At that point there emerged clearly as an ob-
struction a tender attachment to a nurse, who was not friendly
towards analysis; and our efforts, as they really came to pene-
trating the depths, struck upon it. The* child indeed believed
me as to what emerged from the analysis and what I said, but
only up to a certain point a stage to which she had allowed
herself to go and where her loyalty to the nurse began. What-
ever went beyond it struck upon a tenacious and unassailable
resistance. She regressed in fact to an old conflict in the love-
choice between her parents who lived apart, which had played
an important role in her early childhood development. But
this disclosure again did not really help, for the recent attach-

AN INTRODUCTORY PHASE i^

ment to the person of her nurse was a thoroughly real and well-
founded one.

Then I began a keen and sustained battle with the nurse
for the child's affection, conducted on both sides with every
-possible expedient; in it I awakened her criticism, tried to
shake her blind dependence, and turned to my account every
one of the little conflicts which occur daily in a nursery. I knew
that I had won, when one day the little girl told me again the
story of such an incident which had affected her at home, but
this time added "Do you think she's right?" Only from then
on could the analysis penetrate the depths, and it led to the most
promising result of all the cases I have mentioned.

The decision as to whether this method, the battle for the
child itself, is permissible was in this case made without diffi-
culty; the nurse's influence would have been bad not only for
the analysis but for the whole development of the child. But
consider how impossible such a situation is when one has as an
opponent no stranger but the child's parents, or when one is
faced with the question of whether it is worth depriving the
child, in the interests of a successful analysis, of someone's
really favourable and desirable influence. We shall return to
this point in more detail when we consider the question of .the
prospects of the analysis of children and the relationship with
the child's environment.

I shall conclude this subject with two more little stories,
meant to show you how far the child is able to grasp the meaning
of analytical work and of the therapeutical problem.

The best of them comes from the case of the little compul-
sion-neurotic. She recounted to me one day an unusually well-
sustained battle with her devil, and suddenly demanded appre-
ciation. "Anna Freud," she said, "am I not much stronger than
my devil? Can't I control him very well by myself? I don't
think I need you for it at all." I fully confirmed that. She was
really much stronger, and without my help. "But I do need
you," she said after pondering for a minute, "you have to help,
me not to be so unhappy at having to be stronger than it?' I
think that even from a grown-up neurotic one can expect no
better understanding of the change he hopes for from analysis.

And now for the second story. My naughty ten-year-old

14 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

whom I have already described in detail, in a later period of his
analysis got into conversation one day in the waiting room with
one of my father's adult patients. This man told him about his
dog, which had killed a fowl for which he, the owner, had had to
pay. "The dog ought to be sent to Freud," said my little patient,
"he needs analysis. " The grown-up did not reply, but after-
wards showed great disapproval. What odd sort of idea of
analysis did the child have? The dog had nothing the matter
with it; it wanted to kill the hen and it killed it. I knew exactly
what the boy had meant. "The poor dog," he must have
thought, "he wants so badly to be a good dog and something in-
side him forces him to kill hens."

As you see, insight into naughtiness had in the little neurotic
delinquent shifted without difficulty into the place of insight
into the malady, and, thus provided a fully sufficient motive for
analysis.

SECOND LECTURE
The Methods of Children's Analysts

Ladies and Gentlemen. I apprehend that my recent account
of myself will have left an odd impression upon those among
you who are practising analysts. My proceedings altogether,
as I presented them to you, contradict at too many points the
rules for the technique of psychoanalysis as laid down for us
in the past.

Let us review once more the various things I did:

I gave the little girl a positive promise of cure, bearing
in mind the consideration that one cannot demand of a child
that with one who was previously a stranger it should follow
an unknown path to an uncertain end; I fulfilled in this way
her apparent desire to be compelled by authority and wrapped
in security. I openly offered myself as an ally, and joined the
child in criticising its parents.

In another case I embarked on a secret struggle with the
home circle, and courted the child's affections in all possible
ways.

To achieve my aim I exaggerated the possible gravity of a
symptom, and frightened the patient.

And finally I crept into the children's confidence, and
obtruded upon individuals who were firmly of the opinion
that they could do very well without me.

Where in all this is the delicate restraint prescribed for the
analyst; the prudence with which one holds out to the patient
an uncertain prospect of the possibility of cure, or merely of
amelioration; the scrupulous discretion in all personal matters;
the absolute frankness in reviewing the malady; and the full
freedom which one gives the patient to break off the mutual
work whenever he likes of his own accord?

I must defend myself against the suspicion which has
perhaps arisen in you, that I proceeded as I did in ignorance or

1 6 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

unintentional neglect of the prescribed rules. I maintain that
I simply elaborated, to suit anew situation, the elements of an
attitude which without stressing it particularly you all adopt
in dealing with your patients.

Perhaps in my first lecture I exaggerated the difference
between the child's initial situation and that of the adult. You
know how insecure in the early days of an analysis seem the
maintenance of resolution and the patient's confidence. We
are in danger of losing him before he has begun the analysis at
all, and we only feel that our proceedings are on sure ground
when we have him firmly in the transference relation. In these
first days however we work upon him, almost imperceptibly
and without noticing that we are taking any special pains, in
a number of ways which are not so very different from my
laborious and apparently distinctive methods with children.

Take for example a melancholic patient. It is true that
analytical therapy and technique are not directly designed for
such cases, but if one is undertaken a preparatory period of
this kind must be inserted, in which the patient's interest and
resolution for the analytical work is awakened by the analyst's
sympathy and by his entering into his personal needs.

Or take another case. Technical precepts warn us, as you
know, against interpreting dreams too early and thereby
offering the patient knowledge of his inner processes which he
can only reject instead of understanding. But with, an intelligent
and educated compulsion neurotic who doubts everything, we
may be glad to be able to offer him, at the very outset of the
treatment, an especially happy and impressive dream-inter-
pretation. Thereby we interest him and satisfy his exacting
intellectual demands and at bottom we are doing nothing
else but what the children's analyst does, when he shows a
boy that he can do much cleverer tricks with a piece of string
than he can himself.

Another analogy is to be found in the way in which we
show ourselves to be on the side of the rebellious and delinquent
child and ready to help him against his world. We show the
adult neurotic too that we are there to help and support him,
and we take his part exclusively in all conflicts with his family;
proving ourselves thus to be useful.

THE METHODS OF CHILDREN S ANALYSIS I 7

Moreover the factor of power and external authority plays a
part. Observation shows that the experienced analyst with a
reputation finds it much easier to hold his patient and to save
him from 4 'absconding" in the early stages than the young
beginner; and towards him less "negative transference" and
indications of hostility and mistrust are evinced. We ascribe
this difference to the young analyst's inexperience, his lack of
tact in his demeanour towards the patient, his precipitation or
over-caution in interpretation. But I believe that just here
one should take into account the factor of external authority.
The patient asks himself, not without reason, who this man is
after all, who suddenly claims to exercise such prodigious
authority over him; and whether his claims are justified by his
position in the world and the attitude of other, normal, people
towards him. This is not necessarily a matter of the recrudes-
cence of old hostile impulses, but rather perhaps a stirring of
critical commonsense before the patient lets himself slide into
the analytical transference situation. But the eminent analyst
with a name and position obviously enjoys, by virtue of the
esteem in which he is held, the same advantages as the children's
analyst, who in any case is bigger and older than his little
patient, and who becomes a person of undoubted power when
the child feels that his authority is put by the parents even
higher than their own.

Thus these features might be regarded as the elements of an
introductory phase of the treatment, such as I have already
described, with adults as well as children. But I think I am ex-
pressing myself on this incorrectly. It would be more appro-
priate to say that in the technique of the analysis of adults we
find vestiges of all the expedients which prove necessary with
children. The extent to which we use them will depend upon
how far the adult patient with whom we are dealing is still an
immature and dependent being, approximating in this respect
to a child.

So much for the introductory phase to the treatment, the
establishment of the analytical situation. In what follows let us
suppose that the child, by all the foregoing means, has really
won confidence in the analyst, possesses insight into the malady
and is now striving of its own accord for a change in its condition.

1 8 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

So we come to our second theme an examination of the means
at our disposal with a child for the analytical work proper.

In the technique of analysis of adults we have four such ex-
pedients, We turn to account ^nyS!ir!g which the patient's

for the establishment of as com-

Mf*iVf'f a0afn '*''* 3 ' fr< ^ >fa} '

M _ alf , Mt ^Mf*iVf'f

plete a hisJmiLI)J[ his malady as possiDl^r*^"^SpK)y dream

1^^^ r / ^m^ama^m^

mJerpretai^JLpn ; we assess and interpret the ideas brought up by
the patient's free^sooatipn; and finally through the inter-
pretation of his jtr^sf^jp^e^react^ns we obtain access to all
those parts of his past life which can be translated into con-
sciousness in no other way. I must inflict upon you in what fol-
lows a systematic examination of these expedients in their
applicability to and utility for the analysis of children.

In the construction of the case history from the patient's
conscious memories we come across the first difference. In
adult cases, as you know, we refrain from bringing in any in-
formation at all from the patient's family and rely entirely upon
what he can tell us himself. This voluntary restriction is based
on the fact that communications imparted by the relatives are
apt to be unreliable and incomplete,, and take their colour from
the relatives^personal attitude towards the sufferer,
cannQtcontribute much tojhejys^r^nt^^alady.

i^jfiJLp^ ^ oes *lLiS!lJ5^^^"

It is so talcen xTjJlvft^^

parison. Besides, it does not 'know itself when its abnormality
began and when its nature first appeared to be different from
that of other children. It has as yet little notion of comparing
itself with others, and still less of self-appointed tasks by which
it can measure its failures. Thus a children's analyst must in
practice take the case history from the patient's parents. There
is nothing else for it but to make all possible allowance for in-
accuracies and misrepresentations arising from personal
motives.

Contrariwise, we have in dream^Jjiterpr^tion a field in
which ffieaafiuJ^

an^j^sii^ adults. During analysis the child dreams neither less
nor more tKan the grown up, the transparency or obscurity of
the dream content conforms as in the case of adults to the
strength of the resistance. Children's dreams are certainly

THE METHODS OF CHILDREN'S ANALYSIS 19

easier to interpret, if indeed they are not always so simple as the
examples given in The Interpretation of Dreams, We find in
them every such distortion of wish-fulfilment as corresponds to
the complicated neurotic organisation of the childish patient.
But there is nothing easier to make the child grasp than dream
interpretation. At the first account of a dream, I say "No dream
can make itself out of nothing; it must have fetched every bit
from somewhere" and then I set off with the child in search
of its origins. The child amuses itself with the pursuit of the
individual dream elements as with a jigsaw puzzle, and follows
up the separate images or words into real life situations with
great satisfaction. Perhaps this comes about because the child
still stands nearer to dreams than the adult; it may again be
merely because it feels no surprise to find a meaning in dreams,
not having heard the view that they have no meaning. In any
case it is proud of a successful dream interpretation. And
moreover I have often found that even unintelligent children,
who in all other points were as inapt as possible for analysis, did
not fail in dream-interpretation. I have conducted two such
analyses for an extended period almost exclusively by using
dreams.

But even where the associations to the child's dreams fail to
appear, an interpretation is nevertheless often still possible. It
is so much easier to know the child's situation, the daily hap-
penings and significant people in its life. Often one may venture
to insert the missing ideas into the interpretation from one's
own knowledge of the situation. The two following examples of
children's dreams, will merely serve to illustrate these circum-
stances.

In the fifth month of the analysis of a nine-year-old girl I
eventually arrived at the discussion of her masturbation, which
she could only admit even to herself with a strong feeling of
guilt. She felt very hot sensations when masturbating, and her
revulsion against her handling of her genitals extended to these
feelings. She began to be afraid of fire and rebelled against
wearing warm clothes. She could not see the flame burning in a
gas water heater next her bedroom without fearing an explosion.
One evening when the mother was away the nurse wanted to
light the heater, but did not know how and called the elder

1O THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

brother to help. But he did not know how either. The little girl
stood by and had the feeling that she ought to know how. The
following night she dreamed of the same situation,, but in the
dream she actually did help., but did it wrong and the heater ex-
ploded. As a punishment the nurse held her in the fire so that she
would burn up. She woke up in a great state of anxiety and
awakened her moth'er at once to tell her the dream, adding
(from her analytical knowledge) that it was certainly a punish-
ment dream. She brought up no other ideas, but I could easily
supply them in this case. Manipulating the heater stood for
manipulating her own body, which she assumed her brother
did too. "Doing it wrong" was the expression of her own con-
demnation, and the explosion probably represented her form of
orgasm. The nurse, who was the natural person to admonish
against masturbation, appropriately carried out the punishment.

Two months later she had another fire-dream with the fol-
lowing content : ' * On the radiator there were two bricks of different
colours. I knew that the house was going to catch fire and I was
frightened. Then somebody came and took the bricks away" When
she woke up she had her hand on her genitals.

This time she associated an idea to a part of the dream, the
bricks; she had been told that if you put bricks on your head
you do not grow. From that the interpretation could be com-
pleted without difficulty. Stopping growing was one of the
punishments for masturbation which she feared, and we recog-
nised the significance of fire as a symbol of her sexual excitation
from the earlier dream. Thus she masturbated in her sleep, was
warned by the remembrance of all the prohibitions, and was
frightened. The unknown person who took away the bricks was
probably myself, with my soothing reassurances.

Not all dreams occurring in the analysis of children present
so few difficulties in interpretation. But on the whole my little
compulsion neurotic was right when she would announce to
me a dream of the preceding night as follows: "To-day I have a
funny dream to tell you, but you and I will soon find out what it
all means."

The interpretation of daydreams as well as of ordinary
dreams plays an important part in the analysis of children.
Several of the children with whom I gained my experience were

THE METHODS OF CHILDREN S ANALYSIS 21

great daydreamers, and the retailing of their fantasies became
of the greatest assistance to me in analysis. It is usually very
easy to induce children to recount their daydreams, once one has
gained their confidence in other matters. They tell them more
readily and are clearly less ashamed of them than adults, who
condemn daydreaming as "childish." While the adult, from
these considerations of shame and condemnation, usually only
brings his daydreams into the analysis at a late stage and hesitat-
ingly, in a child's analysis their appearance is often of great
assistance in the difficult early stages. The following examples
will give you three types of such fantasies.

The simplest type is the daydream as a reaction to an ex-
perience in the day. The little girl for example, whose dreams I
have just mentioned, at the time when competition with her
brothers and sisters was playing a part of great importance in
her analysis, reacted to a supposed slight setback with the fol-
lowing daydream : "/ wish I had never come info the world at all,
I wish I could die. Sometimes I pretend I do die, and then come lack
into the world as an animal or a doll. But if I do come back into the
world as a doll, I know who I mean to belong to a little girl that my
nurse was with before, who is specially nice and good. I want to be
her doll and I would not mind at all being treated like they treat dolls.
I would be a dear little baby and they could wash me and do anything
to me. The little girl would like me best qf all. Perhaps she would get
another doll for Christmas but I would still be her favourite. She
would never prefer any doll to the baby doll" It is superfluous to
add that of her brothers and sisters the two of whom she was
particularly jealous were younger than her. Her current situa-
tion could not find clearer expression in any account or associa-
tion than it did in this little fantasy.

The six-year-old compulsion neurotic lived at the beginning
of her analysis with friends of her family. She had one of
her fits of naughtiness, which was much criticised by the
other children. Her little girl friend even refused to sleep
in the same room with her, which upset her very much.
.She told me in the analysis however that she had been good,
that the nurse had given her a present of a little toy rabbit, and
assured me at the same time that the other children liked sleep-
ing-with her very much. Then she recounted a daydream which

22 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

she had suddenly had while she was resting. She had not felt at
all that she was making it up. "Once upon a time there was a little
rabbit^ whose family were not at all nice to him. They were going to
send him to the slaughterhouse and have him slaughtered. But he
found it out. He had a car which was very old but could still be
driven. He went for it at night and got in and drove away. He came
to a dear little house in which a little girl (here she used her own
name) lived. She heard him crying downstairs and came down and
let him in. Then he stayed to live with her." Here the feeling of
not being wanted, which she would willingly be spared both in
my eyes and her own, shows itself quite transparently. She
herself is twice present in the daydream as the little unloved
rabbit and as the little girl who treats him as well as she herself
would like to be treated.

A more complicated second type is the continued daydream.

With children who compose such "serial story" daydreams
it is often very easy to get on such terms that even in the earliest
part of the analysis they will daily retail the new instalment.
The current inward situation of the child can be reconstructed
from these day-by-day continuations.

As an example of a third type I will mention a nine-year-old
boy, whose daydreams, though certainly constructed with
varying people and circumstances, repeated in innumerable
situations the same outcome. He began his analysis with the
narration of an abundance of such stored-up fantasies. In many
of them the two principal personages were a hero and a king.
The king threatened the hero, wanting to torture and slay him,
and the hero escaped him in all possible ways. All technical
inventions, especially an air fleet, played a great part in the
pursuit. A cutting machine, which sent out sickle-like knives on
each side when in motion, was also of great importance^ The
fantasy ended with the hero victorious, and doing everything to
the king which the king wanted to do to him. Another of his
daydreams depicted a teacher who punished and beat the
children. The children eventually surrounded and overpowered
her, and beat her to death. Still another had to do with a whip-
ping-machine, in which in the end the torturer was locked in-
stead of the captive for whom it was intended. He still possessed
in his memory a whole collection of such fantasies with endless

THE METHODS OF CHILDREN S ANALYSIS 23

variations. Without knowing anything more about the boy we
can divine that all these fantasies are based on the defence against
and revenge for a castration-threat; that is to say, the castration
is to be carried out in the day dream on the very person who
originally threatened it. You will agree that with such a be-
ginning one can anticipate much of the later progress of the
analysis.

A further technical auxiliary, which besides the use of
dreams and daydreams comes very much to the fore in many
of my analyses of children, isdrawingjjin three of my cases this
for a time almost took the "pTace*^^!! other communications.
Thus the little fire-dreamer, at the time when she was occupied
with her castration complex, incessantly drew pictures of a fear-
ful-looking monster in human shape, with protruding chin,
long nose, an infinity of hair, and a frightful set of teeth. The
name of this constantly recurring monster was "Bitey," and his
function was clearly to bite off the male genital which he
himself had developed in such manifold fashion on his own body.
Another series of drawings which she made in great quantity
during her visits, either as an accompaniment to her stories or
in silence, portrayed all sorts of beings, children, birds, snakes
and dolls, all with enormously extended arms and legs or beaks
and tails. On another page in the same period she assembled all
,of a sudden all the things she wanted to be: a boy (so as to
possess a male member), a doll (so as to be the best-beloved), a
dog (which to her represented virility), and a sailor boy, whom
she took from a fantasy in which she as a boy accompanied her
father on a voyage round the world. Above all these figures was
yet another drawing from a half-heard and half-invented fairy
story a witch pulling out a giant's hair; thus again a repre-
sentation of castration for which at this time she blamed her
mother. In strange contrast to this was a series of pictures from
a much later period, in which a queen presented to a little
princess standing before her a marvellous long-stemmed flower
(obviously another penis-symbol).

The little compulsion-neurotic drew pictures of another
kind. She occasionally accompanied her anal fantasies, which
took up the first part of her analysis, with illustrations. For
example, she portrayed an anal land of Cockayne, in which in-

24 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

stead of the mounds of porridge and tarts of the fairy story the
people had to eat their way through a monstrous accumulation
of pats of excrement arranged in rows. Besides that however I
possess a series of most delicately coloured pictures of flowers
and gardens, which she painstakingly executed with much
neatness and grace while retailing to me her very " dirty " anal
daydreams.

But I fear that I have sketched for you, thus far, too ideal a
picture of the conditions obtaining 4 in the analysis of children.
The family readily furnishes all requisite information; the child
is disclosed as an eager dream-interpreter bringing a rich out-
pouring of daydreams and furnishing a series of interesting
drawings, from all of which conclusions as to its unconscious
impulses may be drawn. If all this is so, it is puzzling to see why
the analysis of children has always been felt to be so difficult, or
why so many analysts declare that they can make no headway in
the treatment of children.

The solution is not far to seek. The child cancels all the fore-
going advantages by reason of the fact that it refuses to associate.
The analyst is thus plunged into perplexity, for the very method
on which the analytical technique is founded becomes to all
intents and purposes useless. It is obviously contrary to.a child's
nature to assume the easy recumbent position prescribed for the
adult, to expunge by an effort of its own will all criticism of
emerging ideas, to exclude nothing from its communications,
and so to explore the surface of its consciousness.

It is indeed true that when one has attached a child to oneself
in the ways I have described, and made oriself indispensable to
it, one can make it do anything. Thus for once in a way it will
occasionally associate on being invited to do so, for a short time
and to please the analyst. Such an interpolation of associations
may certainly be of the greatest use and bring sudden enlighten-
ment in a difficult situation. But it will always be of the nature
of temporary assistance and not the secure basis on which the
whole analytical work can be founded.

I could sometimes ask one little girl, who in analysis proved
particularly docile and amenable to my wishes and who with
her great talent for drawing was especially visually perceptive,
to "see pictures," She would then sit herself down in a remark-

THE METHODS OF CHILDREN'S ANALYSIS 25

uble- crouching attitude and follow attentively her inward
images. In this way she once actually gave me the solution to a
long drawn-out resistance situation. The preoccupation of that
period was the struggle over masturbation and the detachment
from her nurse, to whom she had retreated with redoubled
affection so as to defend herself against my efforts at liberation.
I asked her to see pictures and the first answer was "Nurse is
flying away over the sea." This, with the addition of a vision of
myself surrounded by a lot of dancing devils, meant that I would
be sending the nurse away; and then she would have no defence
against her masturbatory impulses and would be made "wicked"
by me,

Here and there, and more frequently than these deliberate
and invited associations, others, unintentional and uninvited,
come to our help. I take the little compulsion-neurotic again as
an example. At the climax of her analysis it was a matter of
elucidating for her her hatred of her mother, against the know-
ledge of which she had previously defended herself by the
creation of her "devil" as the impersonal deputy fof all her hate-
impulses. Although up to now she had co-operated readily, she
began at this stage to shrink from further progress. At the same
time however she relapsed at home into all manner of insolent
naughtiness, from which .1 daily proved to her that one could
only hate anyone to whom one behaved so badly. Finally she
surrendered outwardly before these constantly recurring proofs,
but demanded to know from me also the reason for such a
hostile feeling towards her apparently well-loved mother. Here
I declined to give further information, for I too was at the end
of my knowledge. Thereupon after a moment's silence she said,
"You know, I believe it is the fault of a dream I once had"
(some weeks before) "that we never understood." I asked her
to repeat it, which she did: "All my dolls were there and my rabbit
as well. Then I went away and the rabbit began to cry most dread-
fully; and I was so sorry for it. I believe I am always copying the
rabbit now, and that is why I keep crying like it did." In reality
of course it was the other way round the rabbit copied her,
not she the rabbit. In that dream she herself had taken the
mother's place, and treated the rabbit as she had been treated
by her. With this dream idea she had finally found the reproach

26 ' TH PSYCHO-ANALYTICAL TREATMENT Otf CHILDREN

which her consciousness always shrank from making towards
her mother: that she had always gone away just when the child
tnost needed hen

Some days 1 later-she repeated the process a second time. I
pressed her, when her whole outlook had clouded over again
after a temporary clearing, to contribute more on the same sub-
ject. She could not do so, but said suddenly in deep thought
" It is so lovely at G. , I should like so much to go there again. "
On closer question it became apparent that in a holiday in that
place she must have passed one of her unhappiest times. Her
elder brother had been sent back to his parents in the town
because he had whooping cough, and she was isolated with the
nurse and two younger children. She added spontaneously,
"The nurse was always cross when I took the toys away from
the little ones." Thus at that time the actual preference of the
nurse for the younger children was added to the supposed pre-
ference of the parents for the brother. She felt herself neglected
on all sides and reacted in her own way. And now she had again
found one ofher deepest reproaches against her mother through
a recollection, this time of the beauty of the countryside in that
place.

I would not emphasise these three cases of surprising associa-
tions if such things occurred more frequently in the analysis of
children. In analysing adults they are, of course, the rule.

This absence of the will to associate in children has led every-
one who up to now has been concerned with the problem of
children's analysis to seek for some substitute or other. Dr.
Hug-Hellmuth attempted to replace the knowledge obtained
from an adult patient's free associations by playing with the
child, seeing it in its own circle, and trying to become familiar
with all its intimate daily circumstances. Mrs. Melanie Klein
substitutes for the adult association technique thejjjsrjjtech-
aicjue with children described in her publications/ohestarfs
from the premise that action is more natural for a little child
than speech, and puts at its disposal a host of tiny playthings,
a world in miniature, so that it can act in the playworld. She puts
all the actions which the child carries out in this way on a par with
the adult's spoken ideas, and attends them with interpretations
as we are used to do with adult patients. It looks at first sight as

THE METHODS OF CHILDREN S ANALYSIS 2*J

though a distressing gap in the technique of children's analysis
had been filled up in an unobjectionable way. I wish to reserve
however for my next lecture an examination of the theoretical
foundation of this play-technique, and to set it in relation to the
last aspect of our present subject, the role of transference in
children's analysis.

THIRD LECTURE
The Role of Transference in the Analysis of Children

Ladies and Gentlemen . I will go briefly over the ground covered
at our last meeting.

We directed attention to the methods of the analysis of
children; we remarked that we have to put the case-history'
together from information furnished by the family, instead of
relying exclusively upon that given by the patient; we became
familiar with the child as a good dream-interpreter, and evaluated
the significance of day dreams and imaginative drawings as
technical auxiliaries. On the other hand I had to report that
children are not inclined to enter into free association, and by
this refusal oblige us to look for some substitute for this most
essential of aids in the analysis of adults. We concluded with a
description of 'one of these substitute methods, postponing its
theoretical evaluation until to-day.-

worked out by Mrs. Melanie Klein is
ing the child. Instead of taking the

time and trouble to pursue it into its domestic environment we
establish at one stroke the whole of its known world in the
analyst's room, and let it move about ih it under the analyst's eye
but at first without his interference. In this way we have the
opportunity of getting to know the child's various reactions,
the strength of its aggressive impulses or of its sympathies, as
well as its attitude to the various things and persons represented
by the toys. There is this advantage over the observation of real
conditions, that the toy environment is manageable and amen-
able to the child's will, so that it can carry out in it all the actions
which in the real world, so much bigger and stronger than itself,
remain confined to a phantasy-existence. All these merits make
the use of the Klein play-method almost indispensable for fami-
liarisation with small children, who are not yet capable of verbal
self-expression,

THE ROLE OF TRANSFERENCE 29

Mrs. Klein however takes an Important further step in the
employment of this technique. She assumes the same status for
these play-actions of the child as for the free associations of the
adult patient, and translates as she goes along the actions under-
taken by the child in this way into corresponding thoughts ; that
is to say, she tries to find beneath everything done in play its
underlying symbolic function. If the child overturns a lamp-
post or a toy figure she interprets it as something of an aggressive
impulse against the father; a deliberate collision between two
cars as evidence of an observation of sexual union between the
parents. Her procedure consists in accompanying the child's
activities with translations and interpretations, which themselves
like the interpretation of the adult's free associations exert a
further influence upon the patient.

"free," that is to say the patient has divested his thoughts of all
direction and influence, but his attitude is nevertheless in-
fluenced by a certain consideration that -he who is associating
has set himself to be analvsed. The child lacks this attitude. I

Jt*^,rfS^ '"'-**,, ..**., , ...

think it is possible, as I have explained before, to give the children
some idea of the purpose of analysis. But the children for whom
Mrs. Klein has worked out her play-technique, in the first
infantile period, are too young to be influenced in this way.
Mrs. Klein considers it as one of the important advantages of
her method that by it she is saved the necessity of such a pre-
paration of the child. JButjthe child's pl^yi&jaotvdoJTUtiated by
the s^m,e p.wrppsiye attitiidels"$,e "adult's free association, there
is no justification, for trQati^Lgitaa.Jip^ipg^he ; sa^e sjigiiificance.
Instead of being invested with symbolic meaning it may some-
times admit of a harmless explanation. The child who upsets a
toy lamp-post may on its walk the day before have come across
some incident in connection with such an object; the car collision
may be reproducing some happening in the street ; and the child
who runs towards a lady visitor and opens her handbag is not
necessarily, as Mrs. Klein maintains, thereby symbolically ex-
pressing its curiosity as to whether its mother's womb conceals
another little brother or sister, but may be connecting some
experience of the previous day when someone brought it a little

3O THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

present in a similar receptacle. Indeed with an adult we do not
consider ourselves justified in ascribing a symbolic significance
to every one of his acts or ideas, but only to those which arise
under the influence of the analytical situation which he has
accepted.

In reply to this objection to the Klein technique it may be
said that a child's play is certainly open to the harmless inter-
pretation just suggested, but why does it reproduce just those
particular scenes with the lamp-post or the cars? Is it not just
the symbolic significance behind these observations which
cause them to be preferred and reproduced before any others in
the analytical hour? It is true, the argument may proceed, that
the child lacks in its actions the purposive attitude of the analyti-
cal situation, which guides the adult. But perhaps it does not
need it at all. The adult must renounce the guidance of his
thoughts by a conscious effort of will and leave their direction
entirely to his unconscious impulses. But the child may require
no such deliberate modification of its situation. Perhaps it is at
all times and in every piece of play entirely surrendered to the
domination of its unconscious.

It is not easy to determine by an exchange of theoretical
arguments the question of whether the equation of children's
play with adults' free association is justifiable or not. This is
obviously a matter for review in the light of practical experience.

Let us try criticism on another point. We know that Mrs.
Klein utilises for interpretation, besides the things which the
child does with the toys provided, all its procedure towards the
objects found in her room or towards her own person. Here
again she follows strictly the example of adult analysis, We
certainly feel justified in drawing into the analysis all the patient's
behaviour towards us during the visit, and all the little voluntary
and involuntary actions which we observe him to perform. In
this we are relying upon the state of transference in which he
finds himself, which can invest even otherwise trivial behaviour
with symbolical significance.

Here the question arises as to whether a child finds itself in
the same transference situation as the adult; in what manner
and in what forms its transference-impulses come to expression ;
and in what they lend themselves to interpretation. We have

THE ROLE OF TRANSFERENCE 3 I

come to the important consideration, of the role of trans/ erence as
a technical expedient in the analysis oj children. The decision on this
question will at the same time furnish fresh material to con-
trovert or support Mrs. Klein's contention.

I explained in the first lecture how I took great pains to
establish in the child a strong attachment to myself, and to bring
it into a relationship of real dependence on me. I would not
have tried so hard to do this, if I had thought the analysis of
children could be carried out without a transference of this kind.
But the affectionate attachment, the positive transference as it is
called in analytical terminology, is the prerequisite for all later
work. The child in fact will only believe the loved person, and
it will only accomplish something to please that person.

The analysis of children requires much more from this
attachment than in the case of adults. There is an educational
as well as an analytical purpose with which we shall later be
concerned in more detail: ,i3^^ n Qt

only in children's ana iy S jg_;^ pomTs*

attachme^

pgggj^^ ^ a t th e establishment of a

transference is in itself enough for our purpose, regardless of
whether it is friendly or hostile. We know that with an adult we
can get through long periods with a negative transference,
which we turn to our account through consistent interpretation
and reference to its origins. But with a^cWJji negative impulses
towards the analyst however revealingpey may be in many
respects are essentially inconvenient,\J|tid should be dealt
with as soon as possible. Thgj^^

I have described the establishment of this affectionate tie
during our discussion of the introductory phase to the analysis
of children. Its expression in fantasies and small or larger
actions is hardly distinguishable from the equivalent processes
in adult patients. We are made to feel the negative reactions at
every point where we attempt to assist a fragment of repressed
material towards liberation from the unconscious, thereby
drawing upon ourselves the resistance of the ego. At such a
time we appear to the child as the dangerous and to-be-feared
tempter ? and we bring on ourselves all the expressions of hatred

32, THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

and repulsion with which at other times it treats its own for-
bidden instinctual impulses.

I will give an account of a positive transference-fantasy from
the six-year-old obsessional patient. The external occasion for
it -was furnished by myself., for I had visited her in her own home
and stayed for her evening bath. She opened her visit on the
nextday with the words/ *you visited mein my bath and next time
111 come and visit you in yours." Some while later she retailed
for me the daydream which she had composed in bed before
going to sleep, after I had gone away. I add her own explanatory
asides in brackets.

"All the rich people did not like you. And your father who
was very rich did not like you at all. (That means I am angry
with your father., don't you think?) And you liked no one and
gave lessons to no one. And my father and mother hated me
and so did John and Billy and Mary and all the people in the
world hated us, even the people we did not know, even the dead
people. So you liked only me and I liked only you and we
always stayed together. All the others were very rich but we
two were quite poor. We had nothing, not even clothes for they
took away everything we had. There was only the sofa left in
the room and we slept on that together. But we were quite
happy together. And then we thought we ought to have a baby.
So we mixed 'a-a and cissies to make a baby. But then we
thought that was not a nice thing to make a baby out of. So we
began to mix flower-petals and things that gave me a baby. For
the baby was in me. It stayed in me quite a long while (my
mother told me that, that babies stay quite a long while in their
mothers) and then the doctor took it out. But I was not a bit
sick (mothers usually are, my mother said). The baby was very
sweet and cunning and so we thought we'd like to be just as
cunning and changed ourselves to be very small. I was "so"
high and you were "so" high. (That is, I think because in our
lesson last week we found out that I wanted to be like Billy and
Mary.) And as we had nothing at all we started to make our-
selves a house out of rose-leaves, and beds out of rose-leaves and
pillows and mattresses all out of rose-leaves sewn together.
Where the little holes were left we put something white in. In-
stead of wall-paper we had the thinnest glass and the walls were

THE ROLE OF TRANSFERENCE 33

carved in different patterns. The chairs were made of glass too
but we were so light, that we were not too heavy for them. (I
think I left my mother out because I was angry with her for not
coming to see me.)" Then there followed a detailed description
of the furniture and all the things that were made for the house.
The daydream was obviously spun out in this direction until she
went to sleep, laying special emphasis on the point that our
initial poverty was finally quite made up for and that in the end
we had much nicer things than all the first mentioned rich
people*

The same little patient at other times related how she was
warned against me from within. The inner voice said, '"Don't
believe Anna Freud. She tells lies. She will not help you and
will only make you worse. She will change your face too, so
that you look uglier. Everything she says is not true. Just be
tired, stay quietly in bed and don't go to her to-day." But she
always told this voice to be silent and said to it that it should be
told of first of all in the next appointment.

Another small patient envisaged me, at the time when we
were discussing her masturbation, in all sorts of degrading
rdles as a beggar, as a poor old woman, and once as just myself
but standing in the middle of my room with devils dancing
round me.

You will notice that we become the object towards which the
patient's friendly or hostile impulses are directed, just as we do
in the case of adults. It might seem from these examples that a
child makes a good transference. Unfortunately that is not
really true. The child indeed enters into the liveliest relations
with the analyst, and evinces a multitude of reactions which it
has acquired in the relationship with its parents ; it give? us most
important hints on the formation of its character in the fluctua-
tion, intensity, and expression of its feelings; but it forms no
transference neurosis.

The analysts amongst you will know what I mean by this.
The adult neurotic gradually transforms, in the course of analy-
tic treatment, the symptom on account of which he sought this
remedy. He gives up the old objects on which his fantasies were
hitherto fixed, and centres his neurosis anew upon the person of
the analyst. As we put it, he substitutes transference-symptoms

34 TOE [PSYCHOANALYTICAL TREATMENT OF CHILDREN

^^^D^Wm : ^yptam\ tran ^ oses his existing neurosis, of
whatever kind, into a transference-neurosis, and displays all his
abnormal reactions in relation to the new transference person,
the analyst. On this new ground, where the analyst feels at
home, he can follow up with the patient the origin and growth
of the individual symptoms; and on this cleared field of opera-
tions there then takes place the final struggle, for gradual in-
sight into the malady and the discovery to the patient of the
unconscious processes within him,

There are two possible reasons why this cannot be brought
about In the case of a small child. One lies within the psycho-
logical structure of the child itself, the other in the child's
analyst.

The child is not, like the adult, ready to produce a new
edition of its love-relationships, because, as one might say, the
old edition is not yet exhausted. Its original objects, the parents,
are still real and present as love-objects not only in fantasy as
with the adult neurotic; between them and the child exist all the
relations of everyday life, and all its gratifications and dis-
appointments still in reality depend on them. The analyst enters
this situation as a new person, and will probably share with the
parents the child's love or hate. But there is no necessity for the
child to exchange the parents for him, since compared to them
he has not the advantages which the adult finds when he can
exchange his fantasy-objects for a real person. Let us in this
connection reconsider Mrs. Klein's method. She maintains
that when a child evinces hostility towards her in the first visit,
repulsing or even beginning to strike her, one may see in that
a proof of the child's ambivalent attitude towards its mother*
The hostile components of this ambivalence are merely dis-
placed onto the analyst. But I believe the truth of the matter is
different. The more tenderly a little child is attached to its own
mother, the fewer friendly impulses it has towards strangers.
We see this most clearly with the baby, who shows only anxious
rejection towards everyone other than its mother or nurse. In-
deed the converse obtains. It is especially with children who are
accustomed to little loving treatment at home, and are not used
to showing or receiving any strong affection, that a positive
relationship is often most quickly established. They obtain

THE ROLE OF TRANSFERENCE 3

from the analyst what they have up till now expected in vain
from the original love objects.

On the other hand, the behaviour of the children's analyst,
as we have described him, is not such as to produce a transfer-
ence that can be well interpreted. We know how we bear our-
selves in the analysis of adults for this purpose. We remain
impersonal and shadowy, a blank page on which the patient
can inscribe his transference-fantasies, somewhat after the
way in which at the cinema a picture is thrown upon an empty
screen. We avoid either issuing prohibitions, or allowing
gratifications. If in spite of this we seem to the patient for-
bidding or encouraging, it is easy to make it clear to him that
he has brought the material for this impression from his own
past.

But the children's analyst must be, anything but a shadow.
We have already remarked that he is a person of interest to
the child, endowed with all sorts of interesting and attractive
qualities. The educational implications which, as you will
hear, are involved in the analysis, result in the child knowing
very well just what seems to the analyst desirable or undesir-
able, and what he sanctions or disapproves of. And such a well-
defined and in many respects novel personality is unfortunately
a bad transference-object, of little use when it comes to inter-
preting the transference. The difficulty here is, as though, to
use our former illustration, the screen on which a film was to
be projected already bore another picture. The more elaborate
and brightly-coloured it is, the more will it tend to efface the
outlines of what is superimposed.

no

In spite of all its positive and
analyst it continues to display its abnormal reactions where
they were displayed before in the home circle. Because of
this the children's analyst is obliged to take into account not
only what happens under his own eye but also what occurs in
the real scene of the neurotic reactions, i.e. the child's home.
Here we come to an infinity of practical technical difficulties
in the analysis of children, which I only lay broadly before you
without going into actual detail. Working from this standpoint
we are dependent upon a permanent news-service about the

36 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

child; we must know the people in its environment and be
sure to some extent of what their reactions to the child are.
In the ideal case, we share our work with the persons who are
actually bringing up the child; just as we share with them the
child's affection or hostility.

Where the external conditions, or the personalities of the
parents, do not allow of such co-operative treatment, certain
material for the analysis eludes us. On this account I had to
conduct some analyses of children almost exclusively by means
of dreams and daydreams. There was nothing interpretable
in the transference and much of the day-to-day symptomatic
neurotic material, never became available to me.

But there are ways and means to bring about an equation
of the child's situation to that of the adult (so; much better
suited for the carrying through of analysis); and so to force the
child into a transference neurosis. This may become necessary
where it is a case of severe neurotic illness in an environment
hostile either to analysis or the child. In such a case the
child would have to be removed from its family and
placed in some suitable institution. As there is no such
institution in existence at present we are at full liberty to imagizie
one, say a home supervised by the children's analyst himself,
or- less far-fetched a school where psychoanalytical prin-
ciples predominate and the work is attuned to co-operation
with the analyst. In both cases a symptom-free period would
first occur, in which the child accustoms itself to the new and
favourable surroundings. The better it feels at this time, the
more unapt and unwilling for analysis shall we find it. We
shall probably do best to leave it quite undisturbed. Only
when it has "acclimatised itself ?> , that is to say when under
the influence of the realities of everyday life it has formed an
attachment to the new environment, beside which the original
objects gradually pale; when it allows its symptoms to revive
again in this new existence, and groups its abnormal reactions
around new personages; when it has thus formed its transfer-
ence-neurosis will it become analysable once more.

In an institution of the first sort, managed by the children's
analyst (and at present we cannot even judge whether such an
arrangement is to be desired) it would then be ( q. matter of an

THE ROLE OF TRANSFERENCE 37

actual transference-neurosis in the sense of the adult's, with
the analyst as focal object. In the other sort we should simply
have artificially bettered the home environment, creating a
substitute home which so to say allows us to see into it, as seems
necessary for the analytical work, and the reactions of which
towards the child we can control and regulate.

Thus the removal of the child from its home might appear
to be the most practical solution. But when we come to consider
the termination of a child's analysis, we shall see how many
objections there are to it. By this expedient we forestall the
natural development at a crucial stage, forcing the child's
premature detachment from the parental objects at a time
when it neither is capable of any independence in its emotional
life, nor has at its disposal, owing to external circumstances,
any freedom in the choice of new love- objects. Even if we
insist on a very long duration for the analysis of children there
still remains in most cases a hiatus between its termination and
the development of puberty, during which the child needs
education, protection, and guidance in every sense of the
words. But what gives us any assurance that after we have
secured a successful resolution of the transference the child
will find of itself the way to the right objects? It returns home
at a time when it has become a stranger there, and its further
guidance is now perhaps entrusted to the very persons from
whom we have forcibly detached it. On inner grounds it is
not capable of self-reliance. We are thus placing it in a position
of renewed difficulty, in which it will find again most of the
original elements of its conflict. It can now take either once
more the path to neurosis or, if this is closed to it by the successful
outcome of the analytical treatment, the opposite line of open
rebellion. From the purely therapeutical point of view this
may seem an advantage; but from that of social adjustment
which in the child's case matters most in the end, it is certainly
none.

FOURTH LECTURE

The Analysis of Children and I heir Upbringing

Ladies and Gentlemen. We have, so far, considered two
aspects of the analysis of children and to-day I will turn to the
third and perhaps most important.

Let me once more retrace our progress. The first part was
concerned, as you may remember, with the introductory phase
in the analysis of children. This has no bearing on analytical
theory. I did not describe all those paltry and childish methods
and occupations, crochetting, knitting, and games, all the
various means of enticement, because I consider them im-
portant for analysis, but on the contrary rather to show what an
intractable subject the child is, and how it is not amenable to
the best-tried methods of scientific therapy but absolutely
requires that its own childish peculiarities should be appro-
priately matched. Whatever we embark on with a child,
whether to teach it arithmetic or geography, whether intending
to educate or analyse, we must always first establish a very de-
finite emotional relationship with it. The harder the work to be
done, the higher must be the strain-capacity of this attachment.
The introduction to the treatment, that is to say the establish-
ment of this tie, thus follows its own rules, determined by child-
ish nature and temporarily independent of analytical theory and
technique.

The second part of my exposition dealt with analysis proper,
and surveyed the paths whereby one can approach a child's
unconscious. It is disappointing that the very best and most
specific expedients in the analysis of adults are not available for
that of children, and that we must fall short of many of the
obligations imposed by scientific theory and obtain our material
where we can find it much as we do in the ordinary way if we
wish to enter into someone's private life. I suspect there is a
further disappointment. Since I have been doing analysis of

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 39

children I have often been asked by analytical colleagues,
whether I have not gained some closer understanding than can
be had from the analysis of adults of the developmental pro-
cesses of the first two years of life, towards which our analytical
investigations are ever more urgently directed. The child, they
say, is still so much nearer to this significant period, its repres-
sions must be still so much less deeply embedded, the overlaid
material so much easier of access, that there should surely be
special facilities for investigation.

So far I have always had to answer these questions with a
negative. The material which the child affords us is indeed, as
you may have noticed from my illustrations, especially clear
and unequivocal. It supplies all sorts of evidence as to the con-
tents of children's neuroses, the presentation of which I shall
reserve for another occasion. It brings much welcome con-
firmation of facts which up to now we have only been able to
assert on conclusions drawn from the analysis of adults. But so
far as my experience goes, with the technique I have described,
it does not take us beyond the boundaries where the child's
speech-faculty begins and so where it thinks in the same way
as we do. The theoretical explanation of this is easy to find.
What we learn in the analysis of adults about this "prehistork^

^ , ayiffg/i^&ff^^^^*^^^^

period is brought to light through free associations and the
interpretation of the transference-reactions; the very two
auxiliaries which leave us in the lurch in the analysis of children.
Besides, our situation may be compared to that of an ethnolo-
gist, who would also seek in vain for a short cut to prehistory in
studying a primitive people instead of a cultured race. He
would miss in the primitive people all the help from the creation
of myth and saga which enables him to draw conclusions in the
case of the cultured people. Similarly with the small child we
lack the reaction-formations and cover-memories which are
only constructed in the course of the latency period, and from
which the later analysis can extract the material condensed in
them. Here again, therefore, the analysis of children offers no
advantage over that of adults but is in fact less able to extract
unconscious material.

And now for the third aspect, the utilisation of the analytical
material which with such painful preparation and by so many

40 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

paths and bypaths we have brought to light. You will be
prepared by now to hear a good deal that is unexpected and
deviates from the classical rules.

Let us first reconsider in rather more detail the corres-
ponding situation in the adult patient. His neurosis is, as we
know, entirely an int^ml affair. It is played out between three
factors, hisjflsl^ his Ego, and hjis 4 .^]upjgr-

ego, whidHast represents* te ethical' and aesthetic demands of
society. The task of analysis is to raise the conflict between
these protagonists to a higher level, by making conscious what
is unconscious. The instinctual impulses were up till now
removed from the influence of the Super-ego by the condition
of repression. Analysis frees them and makes them accessible
to the influence of the Super-ego by which their further, fate
will then be determined. Conscious criticism, the rejection of
part, takes the place of repression, while of the remainder part
can be sublimated away from its sexual aims and part may be
allowed gratification. This favourable outcome is to be ascribed
to the fact that^ the patient's Ego, between the time when it
instituted its original repressions and the point when analysis
achieves its task of liberation,- has undergone its whole ethical
and intellectual "development, and so is in a position to make
other decisions than those which were originally open to it.
The instinctual life must submit to various restrictions, and
the Super-ego must surrender many of its exaggerated preten-
sions* On the common ground of activity in consciousness a
synthesis between the two is brought about.

And now compare with this the conditions of the child
patient's case. The child's neurosis is also certainly an internal
affair, determined by the same three forces, the instinctual life,
the Ego and the Super-ego. But we are already prepared to
find that at two points in the child's case the outer world pene-
trates deeply into its inner situation as a factor indeed incon-
venient for the analysis but organically important. In dis-
cussing the introductory phase required for the analysis of
children we were obliged to ascribe so important a factor as
insight into the malady, not to the child itself, but to the people
surrounding it; and in describing the transference-situation
we demonstrated that the analyst is obliged to share the child's

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 4!

available hostile and loving impulses with the original objects
of these feelings. We are thus not surprised that the outer
world affects the mechanism of infantile neurosis and analysis
more deeply than in the adult case.

We have said that the Super-ego of an adult individual has
become the representative of moral demands made by the
society in which he lives. We know that it owes its origin to
the identification with the first and most important of the
child's love objects, the parents; to them society had trans-
ferred the task of establishing its current ethical claims on the
child and enforcing the restrictions upon instinct which it
prescribes. Thus what was originally a personal obligation
felt towards the parents, only turns into an ego-ideal, inde-
pendent of its prototypes, in the course of development from
object-love for the parents to identification with them.

In the child's case however there is as yet no question of
such independence. Detachment from the first loved objects
lies still in the future, and identification, while the original
object-love is maintained, will only be accomplished gradually
and piecemeal. A Super-ego indeed exists, and many of the
interactions between it and the Ego seem even at this early
period analogous to those of the later and mature develop-
ment. But the "constant relation" between this Super-ego
and the objects to which it owes its establishment must not be
overlooked; we might compare it to that between two recep-
tacles connected together. If in the outer world the level of
good relations with the parents rises, so does the prestige of
the Super-ego and the energy with which it enforces its claims.
If the former is lowered, the Super-ego is diminished as well.

Let us take the infant as the first example. When the mother
or nurse has succeeded in accustoming the little child to the
control of its excretory functions, we soon get the impression
that it fulfils these requirements of cleanliness not only for the
sake of the adult (for love or fear of her), but that it has itself
some interest in the matter, is pleased with its own cleanliness
or vexed if it has an "accident". We notice over and over again,
however, that a subsequent separation from the person who
has inculcated this cleanliness, such as a temporary removal
from the mother or a change of nurse, puts the new achievement

42 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

into jeopardy. The child will become just as dirty as it was
before it learnt the new ways and will only re-acquire them
when the mother returns or an attachment is formed to the new
nurse. Nevertheless the impression that the child had itself
felt an obligation to cleanliness was not altogether deceptive.
The inner prompting exists, but is only worth while to the
child while the, person responsible for its establishment retains
her place as loved object in the outer world. Where the object-
relationship lapses, so does the satisfaction in fulfilling the
obligation.

But even at the opening of the latency-period the same
factors apply. From the analysis of adults we can find ample
confirmation of how much any dislocation of a child's ties
with its parents may disturb its moral development and forma-
tion of character. If at this time it loses its parents through
separation of any kind, or if as objects they are depreciated in
its eyes, perhaps through some such cause as a mental illness
or criminality, its already extensively-constructed Super-ego
is in danger of being lost or depreciated too; so that it can re-
oppose no real inner volition to the instinctual impulses which
press for satisfaction. The origin of many anti-social and
character abnormalities may be explained in this way.

To illustrate these conditions, even at the end of the latency-
period, I will add an example from the analysis of a pre-adoles-
cent boy. I once asked him, whether he was ever aware of any
thoughts which one would prefer not to have. He answered
"Yes, when one wants to steal something". I asked him to
describe such an occasion, and he said "For example when I
am alone at home and there is some fruit, and my father and
mother have gone out without giving me any. Then I get to
thinking how I should like to take some. But then I think
about something else because I don't mean to steal." I asked
if he was always stronger than these thoughts. He said yes,
he had never stolen anything. "What do you do," I said, "when
they are very strong?" "I still don't take anything," he said
triumphantly, "for then I am Afraid of my father."

You observe that his Super-ego has reached a considerable
degree of independence, which was expressed in his own wish
not to be a thief. But when the temptation was too strong he

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 43

must bring in the support of the person to whom this wish
owed its existence, namely the father with the warnings and
threats of punishment associated with him. Another child in
his place would perhaps have called to mind his love for his
mother.

From this weakness and dependence of the claims of the
child's Ego-ideal follows another observation, which can be
confirmed any number of times : the child has a double set
of morals, one for the grown-up world and one for itself and
its contemporaries. We know for example that at a certain
age a child begins to feel shame, that is to say it avoids showing
itself naked, or performing its excretory functions before
strange grown-ups and later even before those best known to
it. But we know too that the same child will undress without
any shame before other children, and they will often want to
go to the lavatory together. Again., we can establish the surpris-
ing fact that a child will only be disgusted at certain things in
the presence of grown-ups, and thus as it were under pressure
from them, while when it is alone or with other children no
such reaction appears. I remember a ten-year-old boy who on a
walk suddenly pointed to a cow-pat and exclaimed with interest
"Look, how funny that is!" The next moment he realised his
mistake and blushed. Later he excused himself to me, saying
he had not at first seen what it was or he would never have men-
tioned it. But I know from the same boy that when he is with
his friends he talks about the excretory functions with amuse-
ment and no embarrassment. He also once assured me that
when he is alone he can touch his own excrement with his
hand without any particular feeling, but when any grown-up
is there he finds it very difficult even to mention it.

Shame and disgust are important reaction-formations
designed to restrain the child's anal and exhibitionistic impulses
from breaking through to gratification; but even when they
are fully established, they depend upon the relationship with
the adult object for their maintenance and efficacy.

With these observations as to the dependent stage of the
childish Super-ego, and the child's double morals in relation
to shame and disgust, we have arrived at the most important
difference between the analysis of children and of adults. The

44 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

former is by no means an entirely private affair, played out
exclusively between two persons, the analyst and his patient.
Insofar as the childish Super-ego has not yet become the
impersonal representative of the obligations undertaken at the
behest of the outer world, insofar as it is still organically con-
nected with it, the relevant outer world objects play an im-
portant role in the analysis itself, and especially in its last part,
the utilisation of the instinctual impulses which have been
freed from repression*

Let us resume once more the comparison with the adult
neurotic. We said that in his analysis we only had to reckon
with his instinctual life, his Ego and his Super-ego; we need
not trouble ourselves with the fate of the impulses which have
emerged from the unconscious. These come under the influ-
ence of his Super-ego, which bears the responsibility for their
further employment.

Where is this responsibility to lie in the case of a child's
analysis? Is it to rest with those concerned with the child's
upbringing, with whom its Super-ego is still inseparably
bound up, that is, with its parents?

But awkward considerations are involved here. It was these
same parents or guardians whose exorbitant requirements
drove the child into an excess of repression and into neurosis.
They, with their unchanged outlook are the very people who
are now called upon to help in its recovery. Only in the most
favourable cases have they learnt enough from the child's
illness to be ready to mitigate their demands. Thus it seems
dangerous to turn responsibility for the newly-liberated
instinctual life over to them. There is too great risk that the
child will be forced once more into the path to repression and
neurosis. In such circumstances it would have been more
economical to have omitted altogether the wearisome and
painful process of liberation by analysis.

Again, in the child's case there is no such long interval
between the formation of the neurosis and its resolution through
analysis as there is in the case of the adult patient, who between
these two stages undergoes his whole Ego-development, so
that the being who made the original choice can hardly be
called the same person as he who undertakes its revision.

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 45

Would it be admissible to declare the child, just because of its
neurosis and its analysis, prematurely of age; and expect from
it itself the important decisions as to how it shall henceforward
deal with the impulses now placed at its disposal? I do not
know to what ethical basis it could have resort, to what criteria
or practical considerations, to enable it to find a way through
these difficulties. I think that, left alone and with every outer
support withdrawn,, it can only find one single short and con-
venient path that of direct gratification. We know however
from analytical theory and practice that, in the very interest of
preventing neurosis, it is desirable to avoid too much direct
gratification at any stage of a child's necessarily perverse
sexuality. Otherwise fixation on the once-experienced pleasure
will prove to be a hindrance to further normal development,
and the urge for its revival a dangerous incentive to regression
from later stages.

So it seems to me that there remains but one solution for
this difficult situation. The analyst must claim for himself
liberty to guide the child at this important point, so as to be
able to make secure, to some extent, the achievement of the
analysis. Under his influence the child must learn how to
conduct itself in regard to its instinctual life, and his views
must in the end determine what part of the infantile sexual
impulses must be suppressed or rejected as unemployable in
the cultural world; how, much or how little can be allowed
direct gratification; and what must be guided into the path of
sublimation, for which process all the available resources of
education can then be used. We may say in short, that the
analyst must succeed in putting himself in the "place of the child' V
Ego-ideal for the duration of the analysis ; he ought not to begin
his analytical work of liberation until he has made sure that the
child is eager to follow his lead. The position of authority
about which we spoke at the beginning, in connection with
the introductory phase in the analysis of children, at this stage
becomes essential ; before the child can give the highest place
in its emotional life, that of the Ego-ideal, to, this new love
object which ranks with the parents, it must feel that the
analyst's authority is even greater than theirs.

If the child's parents have learnt something from its illness ?

46 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

and show an inclination to conform to the analyst's require-
ments, a real division of analytic and educational labour between
home and analyst becomes possible or rather a co-operation
between the two. The child's education suffers no inter-
ruption even at the termination of the analysis, but passes back,
wholly and directly, from the hands of the analyst into those
of the now more understanding parents.

But if the parents use their influence to work against the
analyst the result, since the child is emotionally attached to
both, is a situation similar to that in an unhappy marriage
where the child has become an object of contention. When
the scene is set thus we cannot be surprised if all the injurious
consequences for the formation of character, with which we
are familiar in such cases, occur here as well. In the one instance
the child plays father and mother, in the other analyst and home,
against each other, and in both he uses the conflict as a means
of escape from all obligations. There is peril in these conditions
if a child in a resistance-situation is enabled so to prevail with
the parents against the analyst that they break off the analysis.
The child is lost to the analyst at the very worst moment, in a
state of resistance and negative transference, and is sure to
take advantage in the most undesirable ways of all the liber-
ations already secured by the analysis. To-day I would not
undertake the analysis of a child where the personalities of the
parents, or their analytical understanding, did not provide a
guarantee against such an outcome.

I will give one last example to illustrate how necessary it is
that the analyst should be in control of the relationship between
the child's Ego and its instincts.

When I had brought the six-years-old compulsion neurotic
to the point of allowing her "devil" to speak, she began to
communicate to me a large number of anal fantasies, hesitatingly
at first but soon with ever increasing boldness and detail as she
saw that no expressions of displeasure on my part were forth-
coming. Gradually the analytical hour became entirely given
up to anal confidenc.es, and was the repository of all the day-
dreams of this kind which otherwise oppressed her. While she
talked in this way with me the constant oppression was relieved.
She herself called the time with me her "rest-hour", Sh<?

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 47

once said "My time with you, Anna Freud, is my rest-hour. I
don't have to restrain my devil. But no", she went on, "I
have another rest, when I am asleep. " Thus during analysis
and sleep she was clearly relieved from the equivalent of the
adult's constant expenditure of energy in maintaining repres-
sion. Her relief showed itself above all in an altered nature,
lively and alert.

After a time she went a step further. She began to show
something of her hitherto strictly guarded fantasies and anal
ideas at home as well, making for example, when a dish came
onto the table, a half-audible comparison or a "smutty" joke
to the other children. The lady who then had the care of the
child came to me for advice as to what to do. At that time I
was still inexperienced, and I took the situation lightly, advising
that one should neither acquiesce in nor dissent from such
small manifestations, but simply let them pass unnoticed. The
effect was unexpected. The child lost all moderation, carried
over into her home all the ideas to which she had previously
only given expression during analysis, and completely revelled,
as she had with me, in her anal notions, comparisons, and
expressions. The grown-ups in the house soon found this
intolerable, and losf all appetite especially on account of the
child's behaviour at the common dinner table; and soon it
happened that one after another, children as well as grown-ups,
left the room in silent disapproval. My little patient had
behaved like a pervert or a mentally-afflicted adult, and thereby
put herself beyond the pale of society. Since she was not
penalised by being removed from the company of the others,
the consequence was that they avoided her. By now she had
abandoned all restraints in other respects as well. In a few days
she had become transformed into a cheerful, over-bold and
naughty child, by no means dissatisfied with herself.

Then came the guardian to me a second time, to complain.
She said the state of affairs was unendurable. What ought she
to do? Could she tell the child that talking of such things was
not in itself wicked, but ask her to give it up at home for her
sake? I did not agree to this suggestion. I had to realise that
I had made a blunder, in crediting the child's Super-ego with
an independent inhibitory strength which it did not possess.

48 TH PSYCHO-ANALYTICAL TREATMENT o CHILDREN

As soon as the important people in the outer world had relaxed
their requirements the child's Ego-ideal, which was previously
so strict and had been strong enough to bring forth a whole
series of obsessional symptoms, suddenly became compliant.
I had relied on this compulsive strictness and had been in-
cautious; thereby I had not even forwarded the analysis, I
had for a while made out of an inhibited, obsessional child a
naughty, one might say perverted, one. But I had ruined
the situation for my work. Thjp emancipated child now had
her "rest-hour" all day long, and considerably abated her
enthusiasm for working with me; she no longer furnished
proper material for it, for this was spread over the whole day
instead of being reserved for the analysis, and she had tempor-
arily lost the insight into the malady which is so necessary.
The maxim that gratification should be withheld, if analysis
is to be successful has even greater application to the analysis
of children than to that of adults.

Fortunately the situation was not so bad as it looked and in
practice it was easy to solve it. I bade the guardian do nothing
further, and have a little patience. I would bring the child to
order again, only I could not promise how soon the result
would show. On the child's next visit I acted energetically; I
said all this was a breach of our agreement ; I had thought she
was going to tell me all those things, so as to be rid of them, but
now I saw that this was by no means so. She meant to tell them
to everybody, for the pleasure of doing so. I had nothing against
that, but in that case I could not see that she had any further
use for me; we could simply give up our hours together and
leave her pleasure to her. But if she remained of her first inten-
tion, she must tell these things only to me and to no one else.
The more she refrained from at home, the more would occur
to her wifh me; the more I would know about her and the more
I would be able to rid her of. She must now choose between
the alternatives.

She went very pale and reflected for some time, and then
looked at me and said, with the same thoughtful comprehension
as on the first occasion "If you say that that is how it is I will
not talk like that any more." With that her obsessional con-
scientiousness returned. From that day no mention of the

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 49

objectionable subjects crossed her lips again at home. She
was re-transformed, but she had again become, from a naughty
and perverted child, an inhibited and apathetic one.

I had to accomplish a similar transformation of the same
patient several more times in the course of her treatment.
Always when she escaped, on analytical liberation from her
unusually severe compulsion-neurosis, to the other extreme,
to naughtiness and perversion, there remained nothing for it
but for me to bring about the neurosis again and restore the
already vanished "devil'' once more to his place; each time
naturally in climinishing degrees and with greater precautions
and gentleness than home education had used, until finally I
got the child to hold a middle course between the two extremes.

I would not have enlarged upon this example if it were
not that it serves to illustrate all the characteristics of the
analysis of children put forward in this last section of our dis-
cussion: the fact that a child's Super-ego is weak; that Super-
ego demands and neurosis are dependent on the outer world ;
that the child is unable to control the emancipated instincts;
and that the analyst himself must guide them. 1 The analyst
accordingly combines in his own person two difficult and dia-
metrically opposed functions: he has to analyse and educate,
that is to say in the same breath he must allow and forbid, loosen
and bind again. If he does not succeed in this, analysis becomes
the child's charter for all the ill conduct prohibited by society.
But if he succeeds, he undoes a piece of wrong education and
abnormal development, and so procures for the child, or
whoever controls its destiny, an opportunity to improve matters.

In the case of an adult's analysis, we do not compel the
patient to be well at the end of- it. What he shall do with the
choice newly offered to him lies with him; whether he will
once more take the path into neurosis, whether his Ego-develop-
ment permits his taking the opposite way to extensive instinc-
tual gratification, or whether he will achieve the mean between
the two, a "real synthesis of the two forces within him. We

1 This guidance offers other advantages to the analyst as well. It makes
the application of Ferenczi's "active therapy" possible, the suppression of
individual symptoms, which then go to dam up libido so that more abundant
material should be brought up into analysis.

^O THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

cannot force the parents of our small patients, either, to take a
reasonable course with the child when it is returned to them.
The analysis of children is no insurance against all the mis-
chances which the child's future may hold. It works above all
on the past; thereby indeed it provides a cleared and improved
ground for future development.

From the conditions which I have described you will have
gleaned an important clue as to the indications for the analysis
of children. These indications are not comprised solely in the
fact of the child having a certain malady. The analysis of
children belongs essentially in the analytical milieu, and must
for the present be confined to the children of analysts or %f
people who have been analysed or regard analysis with a certain
confidence and respect. Only so can the transition from the
period of treatment back to home education be accomplished
without a break. Where a child's analysis cannot be organically
grafted onto the rest of its life, but is intruded like a disturbing
foreign body into its other relationships, more conflicts for
the child may be created than can be resolved by the treatment.
This, I am afraid, is another disappointment.

But after telling you so much about the limitations of the
analysis of children, I should not like to close without saying
something of the considerable possibilities which it seems to
me to hold, in spite of all its difficulties, and even with some
advantage over the analysis of adults. I will suggest three of
these.

We can bring about quite other modifications of character
in the child than in the adult. The child, who under the influ-
ence of its neurosis has started out on the path of an abnormal
character-development, need only retrace its steps a short
distance in order to find the road which is normal and suited
to its nature. It has not like the adult built up its whole life,
chosen its calling, made friends, fallen in love, chosen its ideals,
all on the basis of its neurotic tendencies. In the "character-
analysis'* of an adult we must actually shatter his whole life,
and achieve the impossible, that is undo things already done,
and not only make ignored mental processes conscious but
abolish them altogether if we wish for real success. Here the
analysis of children has an infinite advantage.

ANALYSIS OF CHILDREN AND THEIR UPBRINGING 5!

The second possibility concerns influence upon the Super-
ego. The moderation of its severity is, as you know, one of the
purposes of the analysis. Here adult analysis encounters the
greatest difficulties, for it has to contend with the individual's
oldest and most important love-objects, his parents, which he
has introjected through identification, and the memory of
which is protected by filial piety. But in children's cases we
have to do with living persons, existing in the outer world and
not enshrined in memory. When we supplement internal work
by external, and seek to modify, not only the existing identi-
fications by analysis, but their actual prototypes by ordinary
efforts, the result is both impressive and surprising.

The same is true for the third point. In working with an
adult we have to confine ourselves entirely to helping him to
adapt himself to his environment. It is far .from us, and in
fact lies quite outside our intention or our means, to shape his
surroundings to meet his needs. But with a child we can do
just this without any great difficulty, A child's needs are simpler
and easier to fulfil and to oversee; our powers, combined with
those of the parents, easily suffice under favourable conditions
to provide for the child just what it requires, or much of it, at
every stage of its treatment and progressive development. Thus
we lighten the child's task of adjustment as we endeavour to
adjust its surroundings. Here again is a double work, from
within and from without.

I believe that it is due to these three factors that in the analysis
of children, in spite of all the difficulties I have recounted, we
can aim at transformations, improvements, and recoveries
which are not even to be dreamt of in the analysis of adults.

Ladies and Gentlemen! I am prepared for the practising
analysts among you to say, after what they have heard here,
that my methods with children are so different that they
cannot be called real analysis at all, but a form of " wild" analysis
which has borrowed all its expedients from analysis but nowise
conforms to strict analytical principles. But consider: If an
adult neurotic came to your consulting room to ask for treat-
ment, and on closer examination proved as impulsive, as un-
developed intellectually, and as deeply dependent on his environ-
ment as are my child patients, you would probably say, " Freud-

52 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

ian analysis is a fine method, but it is not designed for such
people." And you would treat the patient by a mixed method,
giving him as much pure analysis as he can stand and for the
rest children's analysis because, owing to his infantile nature,
he would merit nothing better.

In my opinion, there can 'be no detraction to the analytical
method, designed as it is for a single particular object, the adult
neurotic, if one seeks to apply it with modifications to other
sorts of object. There is no harm in contriving to use it for other
purposes. Only one should be at pains to know what one is
doing.

PART II

The Theory of Children's Analysis
(1927)

The Theory of Children j Analysis

Ladies and Gentlemen. In recent years the psycho-analysis
of children has attracted greatly increased interest. This is
mainly due to three factors. It brings welcome confirmation
of the conceptions as to the mental life of children which psycho-
analytical theory has formulated from adult analysis over the
course of years; it supplies new disclosures to round out these
ideas from direct observation ; and finally it furnishes a transition
to a sphere of application which, as many think) should in the
future be one of the most important for psychoanalysis : to
pedagogics, or the science of upbringing and education.

But, supported by these three claims to be of service, the
analysis of children presumes to take various liberties. It calls
for a new technique. There can be no real objection to
this, for even the most conservative will admit that altered
problems must be attacked by modified methods. And so there
emerges Melanie Klein's play-technique for small children,
and later the ideas propounded by me for analysis of the latency
period. But some exponents of the analysis of children, and I
among them, go even further. They are beginning to concern
themselves with reflections as to whether the processes in^ a
child's analysis are fully in accordance with those in an adult's,
and whether the two fully coincide, so far as aim and end are
concerned. They think that the children's analyst, just because
the patient is a child, should have besides the analytical school-
ing and outlook a second the educational. I do not see why
we should be frightened of this word, or regard such a com-
pound of two attitudes as a disparagement or analysis. It will
be worth while to test the validity of this view in the light of
some examples.

My first instance is from the analysis of an eleven-year-old
boy. When the treatment began he was of the feminine-
masochistic type, his original object-relationship with his
mother being entirely overlaid by identification with her.

56 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

His original masculine aggressiveness found relief only
occasionally in hostile manifestations towards his brothers
and sisters and delinquent acts, which were followed by
violent fits of repentance and depression. In this period of
his analysis he was preoccupied, in numerous ideas, fantasies
and dreams, with the problem of death, or rather of the infliction
of death.

At that time one of his mother's closest friends was very
ill, and one day his mother received a telegram saying that her
condition was dangerous. He seized on this for an elaborate
day-dream. He pretended that a fresh telegram arrived saying
she was dead. His mother was extremely grieved. Then came
another telegram she is still alive, it was a mistake. The
mother rejoiced. And then he fancied telegrams arriving in
quick succession, always an announcement of death followed
by another of revival. The fantasy ended with the news that
the whole thing was a joke which someone has played on the
mother. It is not difficult to interpret; we see his ambivalence
clearly expressed, the wish to kill the person loved by his
mother, and the inability to pursue his idea to its real conclusion.

Shortly after that, he reported to me the following compulsive
action. When he sat in the lavatory he had to touch a knob
which he found in the wall at one side three times with his
hand; but then he had to repeat the process at once with a
knob on the other side. This action seemed at first unintelli-
gible, until the explanation was found next day through a
fantasy recounted in another connection. He imagined God
as an old man, seated in the heavenly abode on a great throne.
To right and left of him were knobs or switches protruding
from the wall. If he pressed the knobs on one side, someone
died ; if he pressed one on the other a child -came into the world.
I think the combination of the compulsive action with the day-
dream makes further interpretation superfluous. The number
three is probably to be explained by the number of his brothers
and sisters.

Soon afterwards the father of one of the boy's playfellows,
who was a great friend of his mother, fell ill. The boy heard
the telephone ring just as he was leaving for his appointment
with me, and, while with me, constructed the following fantasy:

THE THEORY OF CHILDREN^ ANALYSIS 57

His mother had been told that she must go to the invalid's
house; she went there, entered the sickroom, went up to the
bed and wished to talk with the patient. But he made no reply,
and she saw that he was dead. It was a great shock to her. At
that moment the dead man's little son came in. She called him
and said "Come here, look, your father is dead." The boy
came up to the bed and spoke to his father. The father was
alive and answered him. He turned to my patient's mother
and said "What is the matter? He is alive." Then she spoke
again to the father, but again he made no reply and was dead.
But when the boy came up again and spoke, the father was
alive again.

This fantasy is instructive and transparent, and contains
the interpretation of both the previous ones. We remark that
the father is dead in his relationship to the mother, but alive
so far as concerns his relations with the son. While in the
previous fantasies the ambivalence the wish to kill and to
bring to life again comprised merely two different reactions
towards the same person, which must cancel each other out,
in this one the particularisation of the threatened person (as
man on the one hand and father on the other) gives the historical
elucidation of the double attitude. The two impulses clearly
spring from different phases of the boy's development. The
death-wish against the father as the rival for the mother's love
derives from the normal Oepidus phase with its since-repressed
positive object-love for the mother. Here his masculine aggres-
sion turns against the father; he must be eliminated, to leave
the way free for himself. But the other impulse, the wish to
retain the father, comes on the one hand from the early period
of the purely admiring and loving attitude to the father, undis-
turbed as yet by th& rivalry of the Oedipus complex; and on
the other hand from the phase which here plays the more
important part of identification with the mother, which had
replaced the normal Oedipus attitude. Through fear of castra-
tion, threatening from the father, the boy had surrendered his
love for the mother and allowed himself to be forced into the
feminine attitude. From then on he had to try to sustain the
father as object, of his homosexual love.

It would be tempting to go further, and describe the transi-

58 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

tton in the boy from this wish to kill to a fear of death which
manifested itself each evening; and so to find a key to the com-
plicated structure of this neurosis of the latency period. But
that is no part of my present purpose. I have only mentioned
this fragment to show that this part of the analysis of a child
differs in no wise from that of an adult. We have to free a part
of this boy's masculine aggressiveness from repression, and
from the overlay of his present feminine-masochistic character
and mother-identification. The conflict involved is an inner
one. The fear of his real father in the outer world originally
drove him into carrying out the repression, but the success of
this achievement depends for its maintenance upon inner
forces. The father has been "introjected", the Super-ego has
become the representative of his power, and the fear of him is
felt by the boy as castration anxiety. At every step which the
analysis takes on the path towards making conscious the re-
pressed Oedipus tendencies, it encounters outbreaks of this
castration anxiety as an obstacle. Only the laborious historico-
analytical dissolution of this Super-ego will permit an advance
in my work of liberation. The work and attitude of the treat-
ment are, so far as this part of the problem is concerned, purely
analytical. There is no place here for an educational admixture.
But in contrast listen to another example from the analysis
of the six-year-old obsessional little girl. Here again, it is a
matter of the impulses of the Oedipus complex, and here again
the idea of killing plays a part. The little girl had, as the analysis
disclosed, gone through a time of early passionate love for her
father, and in the usual way had been disappointed in him by
the birth of the next child. Her reaction to that was extra-
ordinarily strong. She surrendered the barely achieved genital
phase In favour of a full regression to anal^sadism. She turned
her hostility against the new arrival. She made an effort,
having turned her love almost completely away from her
father, at least to retain him by incorporation. But her en-
deavours to feel herself a man struck upon the rivalry with an
elder brother, whom she recognised to be better equipped
bodily for this role. The result was an intensified hostility
towards the mother hatred of her, because she had taken the
father from her; hatred, because she had not made her a boy;

THE THEORY OF CHILDREN'S ANALYSIS 9

and finally hatred, because she had borne the child whom my
little patient herself would willingly have brought into the
world. But at this point somewhere in her fourth year
something decisive occurred. She perceived dimly that she
was on the way to losing through these hate-reactions, the
loving relationship which from early childhood she had enjoyed
with her still dearly-loved mother. And in order to rescue her
love for her mother, and still more her own position of being
loved by her, she made a mighty effort to be "good". She
split off, as it were with one stroke, all these hatreds, and with
them her whole sexual life with its anal and sadistic habits and
fantasies; and set this over against her own personality as
something foreign to it, no longer native, something "devil-
ish". What was left behind was not much: a small and limited
person, whose emotional life was not fully at her disposal, and
whose great intelligence and energy were occupied in holding
the "devil" beneath the repression placed on it. For the outside
world, she had at best only lukewarm feelings of tenderness
towards her mother, not strong enough to bear even the slightest
strain, and otherwise an almost complete lack of interest. But
even so the devil occasionally overpowered her for a short
time, so that it might happen that without any real occasion
(externally) she would throw herself down on the ground
and shriek, in a fashion which earlier would certainly have
been dubbed possessed; or she would suddenly yield and
revel with full satisfaction in sadistic fantasies, imagining
that she wandered through her parents' house from top to
bottom smashing all that she found and throwing the pieces
out of the window, and striking off the heads of all the people
she met. Such victories of the devil were always followed by
anxiety and remorse. But the split-off evil had yet another way
of manifesting itself, even more dangerous. The "devil" liked
excrement and dirt; she herself began gradually to develop a
particular anxiety as to the punctilious observance of the pre-
cepts of cleanliness. Beheading was a matter dear to the devil's
heart; she then at a certain time in the morning must creep to
the beds of her brothers and sisters to ascertain whether they
were all still alive. The devil transgressed every human law
with energy and relish; she however developed a fear of

60 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

quake which came on in the evenings before going to sleep
for someone had given her the idea that earthquakes are the
most effective means God uses to punish people on the earth.
So in everyday life she engrossed herself more and more with
reaction' formations, acts of contrition, and reparation for the
deeds of the split-off wickedness. The mighty and urgent
effort, to retain her mother's love and to be socially conform-
able and "good", had come lamentably to grief; it had simply
resulted in a compulsion-neurosis.

But I have not claimed your attention for this infantile
neurosis because of its fine structure and the unusual sharpness,
for this early age, with which the symptoms are circumscribed,
I have described it because of a particular circumstance which
emerged during the therapeutical work.

In the previous example the motor force of the repression
was castration-anxiety relating to the father; naturally this
operated as the main resistance in the analysis. But the analysis
of the little girl worked differently. The repression or rather
the splitting of the child's personality had come into being
under the pressure of anxiety as to loss of love. The anxiety
must have been very intense, to have such a disturbing effect
on the child's whole life. But in this case this motivating anxiety
did not operate in the analysis as a serious resistance. Under
the effect of my uniform friendly interest the. little patient
began to disclose her "bad" side to me quite calmly and natur-
ally. You may think that that was nothing out of the way.
Often enough we meet adult patients who anxiously conceal
their symptoms from the world, and only begin to disclose them
in the secure and uncriticising atmosphere of analysis; who,
indeed, often only recognise them there for the first time.
But this only refers to the ' description of the symptoms ; the
friendly interest and absence of expected criticism never
suffice to induce alteration of them. This however was just
what happened here. When to my interest and lack of con-
demnation there was added a relaxation of the, strict home
discipline, there suddenly occurred a change of anxiety into
the wish concealed beneath it, of a reaction-formation into the
rejected instinct, and of a precaution into the underlying death-
threat. The anxiety as to loss of love ? which should have opposed

THE THEORY OF CHILDREN'S ANALYSIS 6 1

itself in violent outbreaks to such a situation, was hardly mani-
fest at all. The resistance from that cause was slighter than
from any other. It was as though the little girl were saying "If
you do not think it so bad, then f do not either," And with
this diminution of her own demands on herself she gradually
accomplished, in the course of the analysis, a progressive
reincorporation of all the impulses which previously she had
put away with such expenditure of effort: the incestuous love
for her father, the wish to be masculine, the death-wishes
against brothers and sisters, the acknowledgement of her
childish sexuality; and only paused with the single serious
resistance for a time before what seemed to her the worst of all,
the acknowledgement of the direct death-wish against her
mother.

That is not the behaviour which we have learned to expect
from a Super-ego. We have learned from the adult neurotic
how inaccessible to reason the Super-ego is, how steadfastly
it resists every attempt at external influence, and how it will
not consent to modify its demands until we have historically
dissected it in analysis and traced back every single command
and prohibition to the identification with one of the persons
who loomed large and were loved in childhood.

I believe that we have come here upon the main and most
important difference between the analysis of adults and that of
children. Take the situation in adult analysis, where the Super-
ego has already achieved its independence. Here our sole task
is to raise all the impulses deriving from the Id, the Ego and
the Super-ego, which partook in the formation of the neurotic
conflict, to the same level by bringing them into consciousness,
On this new conscious level the conflict can then be carried on
in a new way and brought to another outcome. But in the
analysis of children we deal with cases where the Super-ego
has not yet arrived at any real independence; where it operates
all too clearly for the sake of those from whom it holds its
commission, the parents and persons in charge of the child,
and is swayed in its demands by every change in the relation-
ship with these people and by all the alterations that may occur
in their own outlook. We work, as with adults, by pur analysis,
in so far as it is a matter of freeing the already repressed part

62, THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

of the Id and the Ego. But the task with the childish Super-ego
is a double one. It is analytical in the historical dissolution of
the Super-ego, so far as it is already an Independent structure,
from within, but it is also educational (in the widest sense of
that word) in exercising outward influence, by modifying the
relations with those who are bringing up the child, creating
new impressions, and revising the demands made on the child
by the outside world.

To return to my little obsessional patient. Had she not come
under treatment at six-years-old her infantile neurosis might
-perhaps, like so many others, have cleared up of itself. As heir
to it a strict Super-ego would certainly have been raised up,
which would have presented rigid demands to the Ego and
would have opposed to any later analysis a resistance difficult
to overcome. But the view which I put forward is that this
strict Super-ego stands at the outcome and not at the inception
of the infantile neurosis.

As a further illustration of what I have said I refer to a
communication which Dr. M. W. Wulff has published. (73.)
He reports phobic attacks of anxiety in a little girl aged only
one and a half. Clearly in this case the child's parents had
tried too early to make it form habits of cleanliness. The little
child could not come up to their requirements and became
upset, imagining that she would be sent away. Her anxiety
became acute in the dark or when there were sounds, for
instance if someone knocked at the door. She constantly
asked whether she was good and kept repeating the plea not
to be sent away. The worried parents turned to Dr. Wulff
for advice.

The interesting point about this early symptom is that the
infant's anxiety, which Dr. Wulff at once recognised as fear
of loss of love, is in no way distinguishable from the guilt-
feelings of an adult neurotic. Must we however in this case
give credence to so early a development of conscience, and thus
of the Super-ego?

Dr, Wulff explained to the parents that the little girl clearly
could not yet for some reason carry out the requirements of
cleanliness, and advised them to postpone for a time her educa-
tion in this respect. They were understanding enough to com-

THE THEORY OF CHILDREN'S ANALYSIS 63

ply; they explained to the child that they still loved her when
she wetted herself, and they tried whenever that happened to
allay her fears with renewed reassurances. The result as Dr.
Wulff described it was striking. After a few days the child was
calm and free from anxiety.

Such "therapy" is naturally only possible very seldom and
with very small children. I do not want to suggest that it is
the only possible one. But Dr. Wulff has here afforded a proof
by cure, which permits a positive conclusion as to the play of
forces at the root of the anxiety. If the child's anxiety had been
due to the Super-ego's demands, the parents' reassurances
would have had hardly any influence on her symptom. If
however the cause of her anxiety was the real fear of the dis-
pleasure of her parents, actually existing in the outside world,
and not of an inward image of them, then it is easily to be
understood that the symptom could be removed. Dr. Wulff
had in fact removed its cause.

The Super-ego's accessibility to influence in early years
accounts for many of the direct modifications which can be
brought about in a young child's behaviour. Through the
good offices of Dr. Ferenczi, I have had access to the notes of a
teacher in a modern American school^ the Walden School.
She describes how neurotic children from strict homes ? who
come to school while still of kindergarten age, after a first
period of surprise and suspicion become acclimatised to the
free atmosphere and gradually lose their neurotic symptoms,
which are usually reactions to the breaking off of masturbation.
A similar result would be impossible in the case of an adult
neurotic. The freer the surroundings into which he is trans-
planted, the stronger his anxiety in respect of the instinct, and
the stronger his neurotic defence reactions, i.e. his symptoms.
The demands which his Super-ego lays upon him are no
longer open to influence from his surroundings. On the other
hand, the child, when the mitigation of its Super-ego's demands
once has begun, is apt to go to extremes, and to indulge itself
further than even the freest environemnt is ready to permit.
The exercise of external influence is again necessary.

In conclusion, one more example. A little while ago I over-
heard a conversation between a five-year-old boy and his

64 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

mother. The child had taken the fancy to wish for a live horse;
his mother on good grounds opposed the fulfilment of this,
desire. "It doesn't matter," said he, not at all cast down, "I'll
wish for it for my next birthday." His mother told him that
even then he could not have it. "Then I'll wish for it at Christ-
mas/' he said, "one gets anything then/* "No, not even at
Christmas/' said his mother, trying to disabuse him. "Well it
still doesn't matter," said he triumphantly, "I shall buy it
myself, for I allow myself to have it" This is a clear illustration
of the conflict which arises when an inner permission is con-
fronted by a prohibition from without. If they are fortunate,
children will adapt themselves to frustration ; if not, the out-
come may be rebellion and delinquency, or neurosis.

Yet one word more on the "educational" function of the
children's analyst. Since we have found that the forces with
which we have to contend in the cure of an infantile neurosis
are not only internal, but partly external as well, we have a
right to require that the children's analyst should correctly
"assess the external situation in which the child stands; just as
we ask that he should measure and comprehend its inner
situation. For this part of his task however the children's
analyst needs theoretical and practical knowledge of children's
training and upbringing. This enables him to look into and
criticise the educational influence under which the child is
being brought up ; and, if it should prove necessary, to take the
child's upbringing out of the hands of those in charge, and for
the period of the analysis undertake it himself.

PART III

Indications for Child Analysis
(1945)

INTRODUCTION

1 . The sexual prejudice.

2. The fear of immorality as a consequence of child analysis.

3. Controversies about technique.
Controversies concerning the appropriate age.
Controversies concerning the range of application.

THE EVALUATION OF INFANTILE NEUROSES

1 . Selection of Cases.

(a) The factor of neurotic suffering.

(b) The factor of disturbance of normal capacities.

(c) The factor of disturbance of normal development.

2. "Libidinal Development

(a) The sequence of libidinal development.

(b) The intactness of libidinal development.

(c) Neurotic interference with libidinal development;

the factor of spontaneous recovery.

3. Neurotic Interference with Ego-Developmetft

(a) The quantitative factor,
(h) The qualitative factor.

CONCLUSION

INTRODUCTION

Since 1905, when a phobia in a five-year-old boy was first
treated by psycho-analysis the father acting as intermediary
between child and analyst child analysis as a therapeutic
method has had a stormy and much chequered career (74).
There is hardly a point in it which has remained uncontested,
or which has not, at some time or other, become the starting-
point for controversy.

In some respects child-analysis revived the same objections
which the psycho-analytic treatment of adults had to meet and
overcome a full decade earlier.

1. The sexual prejudice

At the end of the last century the conception of a sexual
origin of adult .neurosis ran counter to all the prejudices of
that age. But, though medical and lay opinion would not
concede to adult sexuality the pathogenic importance which
it deserved, no one went so far as to deny its existence alto-
gether; everybody on the other hand violently objected to
the possible existence of a sexual life in childhood. Psycho-
analysis had laid itself open to the reproach of over-estimating
the role of sexuality in the adult, and, similarly, to a charge of
inventing an infantile sex life, contrary to the facts then known
and accepted by the medical world and in educational circles.
Thus the existence of an infantile sexuality had to be established
and proved at the same time as the role of such a sexual life
for the neuroses of childhood had to be demonstrated (75),

2. The fear of immorality as a consequence of psycho-analytic

treatment

A second argument which was originally used against the
analytic treatment of adult neurotics was based on a mis-
conception of the psycho-analytic process itself. It was thought
that the constant preoccupation with instinctive tendencies
which is inherent in the analytic work ? the release of these

68 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

tendencies from repression, and their consequent rising up to
consciousness could have one effect only: their expression in
actions, i.e. the fulfilment of the instinctive (sexual and aggres-
sive) wishes which had been kept under restraint before the
treatment. Psycho-analytical treatment would thus lead
directly to immorality and licentiousness. It had needed much
patient and lengthy demonstration to convince the public
that this was not the case ; that, on the contrary, far from becom-
ing more potent, unconscious tendencies were deprived of
most of their power when an outlet into conscious thought was
opened up for them. Relegated to the unconscious these
instinctive urges had been out of reach; unearthed, and lifted
to the conscious level they automatically came under the
control of the patient's mind and could be dealt with according
to his ideas and ideals.

The same objections which had been successfully refuted
with regard to adult patients rose up again in full force when
child-analysis made its first appearance. The argument was
this time that surely the childish mind could not be trusted
with the same discretion in dealing with its reawakened
instinctive tendencies as the adult one. Surely the child would
want to make full use of the licence offered to it in the analytic
situation and give free rein to its instinctive urges inside and
outside of the analytic hour. Or even if its intentions were
otherwise, its attempts at restraint and adapted behaviour
would be simply overrun by the instinctive forces let loose
through the agency of analytic treatment. Fears of this kind
were expressed not only by doctors, teachers and parents, but
were shared to a degree by some analysts who thought it
quite possible that child-analysis might need some special
form of educational guidance as its constant accompaniment
and counterpart. But, as experience proved, this was not
as often necessary as had been expected. It was demonstrated
repeatedly that the ego and super-ego of a child which were
consistent and severe enough to produce an infantile neurosis
could also,, with sonje help, be relied on to deal with the sexual
and aggressive impulses which emerged from repression after
the neurosis had been analysed successfully. Fears of this
nature are more justified where the object of child-analysis is

INDICATIONS FOR CHILD ANALYSIS 69

not a neurotic, but a dissocial, delinquent, or otherwise de-
ficient character.

3. Controversies about the technique of child-analysis

It became obvious immediately that the classical analytical
technique was not applicable to children, at least not before
the age of puberty, or at best pre-puberty. Free association,
the mainstay of analytic technique, had to be counted out as
a method; young children are neither willing nor able to
embark on it. This has its consequences for the second main
road to the unconscious, namely dream-interpretation. Children
tell their dreams freely; but without the use of free association
the interpretation of the manifest dream content is less fruitful
and convincing. The child-analyst frequently has to supply
the links between the manifest dream content and the latent
dream thoughts according to his own intimate knowledge of
the child's inner situation at the time of dreaming. It is, further,
impossible to establish the same outward setting for the analytic
hour. Children cannot be placed on the analytic couch for the
purpose of relaxed concentration without this having the
effect of silencing them completely. Talk and action cannot be
separated from each other in their case. Nor can the patient's
Family be wholly excluded from the analysis. Insight into the
seriousness of the neurosis, the decision to begin and to continue
treatment, persistence in the face of resistance or of passing
aggravations of the illness are beyond the child, and have to
be supplied by the parents. In child-analysis the parents* good
sense plays the part which the healthy part of the patient's
conscious personality plays during adult analysis to safeguard
and maintain the continuance of treatment.

To establish techniques which were adapted to the varying
needs of the different phases of childhood, it became above
all necessary to create appropriate substitutes for free associa-
tion. The first divergence of opinion between child-analysts
arose about this matter. Certain child-analysts (Hug-Hellmuth
in Vienna, Melanie Klein in Berlin and later in London)
developed the so-called play technique of child-analysis, a
method which promised to give more or less direct access to
the child's unconscious. In this technique, for free association

JO THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

was substituted the spontaneous play-activity of the child,
carried out on small toy material which was offered by the
analyst for free use within the analytic hour. The individual
actions of the child in connection with this material were
considered to be equivalent to the individual thoughts or
images in a chain of free association. In this manner the pro-
duction of material for interpretation became largely inde-
pendent of the child's willingness or ability to express itself
in speech.

Other child-analysts (on the European continent and in
the United States) were reluctant to employ this play technique
to the same extent. This method of interpretation, though
allowing as if in flashes a certain amount of direct insight into
the child's unconscious, seemed to them to be open to objec-
tions of various kinds. Like all interpretation of symbols (for
instance purely symbolical dream-interpretation) it has a
tendency to become rigid, impersonal and stereotyped with 1
out being open to corroboration from the child; it aimed
at laying bare the deeper layers of the child's mind without
working through the resistances and distortions of the pre-
conscious and of consciousness. Furthermore they refused to
accept these activities as real equivalents of free association.
The free associations of the adult patient are produced in the
set situation of analytic transference and, though freed from
the usual restrictions of logical and conscious thought, are
under the influence of one governing aim; that of being cured
by analysis. The play activity of the child is not governed by
any similar intention. This leads to the further, open and con-
troversial question whether the relationship of the child to the
analyst is really governed exclusively by a transference situa-
tion. Even if one part of the child's neurosis is transformed
into a transference neurosis, in the manner in which this
happens in adult analysis, another part of the child's neurotic
reactions remains grouped around the parents who are the
original objects of the pathogenic past. It was due to consider-
ations of this nature that a large number of child-analysts
evolved techniques of a different kind. They worked on the
various derivatives of the child's unconscious in day- and
night-dreams, in imaginative play^ in drawings, etc T , including

INDICATIONS FOR CHILD ANALYSIS 71

the emotional reactions of the child, inside and outside of the
analytic hour. The task was, as in adult analysis, to undo the
various repressions, distortions, displacements, condensations,
etc., which had been brought about by the neurotic defence-
mechanisms, until, with the active help of the child, the un-
conscious content of the material was laid bare. Such co-
operation with the child naturally presupposes the extensive
use of speech.

Detailed accounts of the two different types of child-analysis
are contained in Melanie Klein's The Psycho-Analysis of Children
(5), and in my Introduction to the Technique of the Analysis of
Children (4).

The method of symbolic interpretation of play activity which
Melanie Klein had devised for her technique was later taken
over by psychotherapy and widely used in England and
America under the name of "play-therapy". But in these
instances it was deprived of its full original meaning, since
it was used without reference to an analytical transference
situation,

4, Controversies concerning the appropriate age for child-analysis
Differences in the manner in which child-analysis was
carried out inevitably led to differences concerning the age at
which the therapeutic method was applicable. The decisive
factor in this respect was the use of speech. Melanie Klein
and her followers repeatedly expressed the opinion .that, with
the help of the play technique, children can be analysed at
almost any age, from earliest infancy onwards. When the
faculty of speech in the child is of major importance for the
treatment, it is hardly possible to contemplate analysis before
the age of two or three. The majority of cases treated with
these latter techniques were considerably older than that;
many of them were analysed atti^^
complex (four or fi ye j[2^ 5 or m ^ e ' a ^ eiic 7 period.

5* Controversies concerning the range of application of child-analysis
Here again a wide difference of opinion exists between the
school of Melanie Klein and the former Vienna school of child-
analysts, many of whom are at present working in America.

7& THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

The English child-analysts express the view that every child
passes in its infancy through phases of grave abnormality
(psychotic states, depressions, etc.), and that normal develop-
ment in later stages can best be safeguarded by early child-
analysis, by analysing the psychotic residues of the earliest
stage whenever outward circumstances permit. The former
Vienna school on the other hand is of the opinion that the
application of child-analysis may well be restricted to the most
severe cases of the infantile neurosis through which every
child normally passes at one time or other before entering the
latency period. With all other children, the application of
analytical knowledge to their educational handling may prove
sufficient to guide them through the intricacies of their in-
stinctual and emotional development.

THE EVALUATION OF INFANTILE NEUROSES

I . Selection of cases

Those who do not share the opinion that analysis should
be universally applied to all children are faced with the task of
selecting their cases, that is of assessing the seriousness of
the various manifestations of infantile neurosis. In practice
child-analysts of to-day have little opportunity of determining
this matter by their own judgment. The question whether or
not a child should be analysed is usually decided for them, and
frequently enough on inadequate reasons. Children who are
severely ill are often withheld from treatment because their
parents, with whom the decision lies, know too little about
analysis, or are frightened of the little which they know;
because the parents are reluctant to have the intimacies of
their own lives exposed to the analyst; because they fear the
sexual enlightenment of the child; because they, especially
the mothers, are unwilling to see a stranger succeed with their
child where they themselves have failed. Sometimes the
reasons given are very superficial : analytic hours would clash
with school hours ; would take up the time otherwise given to
sport or handicraft, or some other occupation, from which the
child usually has ceased to benefit owing to its neurotic disturb-

INDICATIONS FOR CHILD ANALYSIS 73

ance. The most decisive factor is frequently the geographical
one. To accompany a child to and from a daily analytical hour
is a heavy burden on the mother ; where long distances aggravate
the issue, this factor is often prohibitive.

On the other hand, a number of children are sent into
analysis, not because they suffer from an excessive form of
infantile neurosis, but because their parents, either as analytic
patients themselves, or as practising analysts, are more apt
than others to detect and evaluate signs of neurotic behaviour
whenever they appear. They readily decide for analytic
treatment at an early stage to avoid for their child the graver
forms of neurotic suffering which they know only too well
from personal experience. Their positive decision for treat-
ment, like the above mentioned negative ones, is based rather
on a personal attitude than on an objective assessment of the
child's disturbance.

The child cases actually in treatment in our day, either
in child departments of the psycho-analytic clinics or in private
practice, are thus a more or less chance selection, not a repre-
sentative selection of infantile neuroses which are most in
need of therapeutic help. It is to be expected that these condi-
tions will change when knowledge about the mental develop-
ment of the young child becpmes more widespread, that is,
when parents understand at least as much about the importance
of instinctual, emotional or intellectual setbacks in the child's
development as they understand now about its bodily illnesses.
The assessment of the disturbance and the decision whether
treatment is indicated or not will then bp left to the psych-
ologist or psycho-analyst, as it is nowadays left to the pedia-
trician in all cases of organic disturbance.

(a) The factor of neurotic suffering

The question whether or not an adult neurotic seeks treat-
ment is in the last resort dependant on the amount of suffering
which his neurotic symptoms cause him. For this reason
neurotics undergo treatment more willingly than for instance^
perverts. A perversion disrupts normal life as much as a
neurosis. But the perversion brings satisfaction whereas
l^eurotic symptoms are painful ,

74 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

This statement can be upheld in spite of the fact that every
neurosis is also a source of pleasure for the individual who is
afflicted by it. The pleasure which the patient derives from the
distorted gratification of repressed wishes, that is from his
symptoms, is not 'experienced as pleasure by his conscious
system. The conscious pleasure, on the other hand, which
neurotics often enjoy "owing to the consideration which they
receive from their environment, a sense of importance, etc,,
is of a secondary nature and not really inherent in the illness.
Whenever this secondary gain from the illness becomes greater
than the neurotic suffering itself, the patient will be unfit for
treatment, or will in most cases quite openly refuse to be
treated. The existence of neurotic suffering is, if not indis-
pensable, at least an important prerequisite for the attitude of
persistence and determination which a patient needs to carry
him through the difficulties of an analytic cure.

In dealing with cases of infantile neurosis one realises that
neurotic suffering is not present in the child to the same degree,
and that, wherever it is present, it is equally divided between
child and parents. In some instances it is only the reaction of
the parents to the symptom which, secondarily, brings home
to the child that it suffers from a symptom, This is, for instance
the case in the frequent feeding disturbances of childhood.
Children become bad eaters for reasons which originate in
their early mother-relationship, in their reactions against their
oral-sadistic and their anal-sadistic tendencies, etc. The
normal intake of food is thus made difficult or impossible for
neurotic reasons. The child, left to itself, would gladly put
up with this symptom and eat less. Mothers, on the other hand,
suffer acutely from anxiety caused by this behaviour of the
child and, in their turn, inflict suffering on the bad eater through
reproaches, scoldings, forcible measures, etc. The same occurs
in the neurotic bed-wetting of childhood. Children under a
certain age tend to show indifference towards this symptom
while the adult environment suffers badly on its account; the
amount of pain which it causes the child depends on the
reaction of the environment. The night terrors of children
(pavor nocturnus) usually cause consternation and anxiety to
the parents while the afflicted child itself remains oblivious of

INDICATIONS FOR CHILD ANALYSIS 75

them. Temper tantrums are disturbing for the family; for the
child itself they are often a welcome outlet. Neurotic display
of aggression and destructiveness, as they occur in the initial
stages of an obsessional neurosis, are most disturbing symp-
toms for the family; the child rather indulges in them. Its
attitude in that respect resembles more closely that of an adult
pervert than of an adult neurotic.

Acute neurotic suffering is felt by the child in all states of
anxiety before a consistent defence against it has set in. When
anxiety is once warded off, either by phobic or by obsessional
mechanisms, how much the child suffers depends agaia on the
behaviour of the environment. Many mothers fear the child's
anxiety as much as the child does himself. Consequently
they not only do not oppose the child's phobic or obsessional
arrangements, they even help actively and in many ways to
uphold them. They help the child to avoid the danger situa-
tions in which anxiety would arise ; they fall in with bed-time
ceremonials, with eating, dressing and washing obsessions,
etc. Their object is to spare the child the suffering inherent
in the^anxiety, and simultaneously to avoid the violent out-
breaks which follow whenever an obsessional act or phobic
precaution is opposed or prevented. There are thus many
infantile phobias and obsessional neuroses which exist under
the surface and, though causing endless trouble for the mother,
are not felt as acutely painful by the child.

(During the time of mass evacuation in England, 1940,
many children became neurotic sufferers after separation from
their parents. It would be- erroneous to conclude that they had
acquired a neurosis due to their traumatic experiences. In
many cases their neurosis had merely not been in evidence
while they lived with their mothers, and acute anxiety, suffering,
etc., appeared when they had to live with people who were less
willing or able to show consideration for their phobic and
obsessional arrangements.)

To sum up : the presence or absence of suffering cannot be
counted on as a decisive factor when making up one's mind
about the treatment of a child. There are many serious neurotic
disorders which the child bears with equanimity; there are less
serious ones which cause pain. Since the decision to seek

76 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

advice for the child normally lies with the parents, an infantile
neurosis is more likely to come into treatment when its symp-
toms are disturbing to the environment. The parents will be
guided in their assessment of the seriousness of the situation
by the impact of the child's neurosis on themselves. They
show more concern, for instance, about aggressive and destruc-
tive states than about inhibitions; obsessional acts are taken
more lightly than anxiety attacks, though in reality they repre-
sent a more advanced stage of the same disorder; bed-wetters
are taken to clinics more regularly than any other category of
cases; the beginning stages of passive feminity in young boys,
though often decisive for their whole future abnormality, are
almost invariably overlooked.

(b) The factor of disturbance of 'normal capacities

An adult neurosis is not only assessed subjectively according
to suffering, but objectively according to the extent to which
it damages the main capacities of the individual : the capacity
to lead a normal love and sex life, and the capacity to work.
Patients usually decide to come into treatment when*one or
the other of these functions, or both, are severely threatened.

The question arises whether there are any functions in the
child's life, the disturbance of which is an equally significant
indicator for the seriousness of the infantile neurosis.

The child's love and sex life is, as psycho-analysis has shown,
not less extensive and certainly not less intensive than that of
the adult. But, after the first severe repressions of early child-
hood have occurred, it is inhibited in its aims. Though centred
according to objects (Oedipus complex), it is diffuse in its
manifestations (component instincts), not organised under the
primacy of any single one of them, It furthermore lacks a
climax in its expressions, the disturbance of which could be
taken as indicative of disturbance of function. The child is,
according to the nature of its sex organisation, impotent,
which means that the intactness of its sexuality is more difficult
to gauge than with an adult. To measure its capacity for object*
love we can only measure its libidinal urges directed towards
the outer world against its narcissistic tendencies. Normally
after the first year of life object love should outweigh narcissism ;

INDICATIONS FOR CHILD ANALYSIS JJ

satisfaction derived from objects should become increasingly
greater than autoerotic gratification. An infantile neurosis can
seriously interfere with these proportions. But the assessment
of these factors in the diagnosis is too subtle and too complicated
to be of immediate help as an indication for treatment.

It is equally difficult to find in the child's life a parallel for
the disturbance of working capacity. It has been suggested
by many authors that play is as important for the child as work
is for the adult, and that consequently a test of the child's ability
to play is highly suggestive for the extent of its disturbance.
This view seems to be borne out by the fact that neurotic
children are invariably disturbed in their play activity. With
certain types of neurosis imaginative play is excessive, at the
expense of constructive play. In its initial stages this is some-
times taken as an asset by the parents, as the sign of a specially
vivid imagination and of artistic gifts. But the neurotic element
is unmistakable when such play becomes repetitive, -monoton-
ous, and interferes with all other kinds of activity. This should
be taken as a sign that the child is neurotically fixed to a certain-
point of its libidinal development.

Although the capacity for constructive play is, in the child's
life, the nearest substitute for the adult capacity to work, the
two functions remain so far removed from each other that it
is hardly justifiable to give them an equal place in the diagnosis.
Since play is governed by the pleasure principle, and work by
the reality principle, the disturbance of each of the two func-
tions has a different clinical significance,

(c) The factor of disturbance of normal development

It is thus impracticable to use for the evaluation of an
infantile neurosis the same criteria which we apply in the case
of an adult. Childhood is a process sui generis^ a series of
developmental stages in which each manifestation has its im-
portance as a transition, not as a final result. Its tasks and
accomplishments cannot therefore be compared with those of
the more static stage of adulthood, There is only one factor in
childhood which has such central importance that its impair-
ment through a neurosis calls for immediate action: that is the
child's ability to develop, not to remain fixed to any stage of

78 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

development before a prescribed ripening process has been
concluded. The suggestion is therefore to assess the serious-
ness of an infantile neurosis, not according to the damage which
it does to the activities or attitudes of the child in any special
way, or at any given moment, but according to the degree in
which it prevents the child from developing further.

2. LIBIDINAL DEVELOPMENT

(a) The sequence of libidinal development

On the basis of our present knowledge it is possible, even in
a cursory examination, to establish whether a child is up to
its age in its libidinal development. We roughly know the age
limits for the pregenital organisations of the libido, plus some
subdivisions within these stages. Gross disturbance in the
order of events, or failure to move on from any of these transi-
tory stages in children who are neither organically nor mentally
deficient, points to serious neurotic interference.

But wide individual variability, and the scantiness of our
knowledge, prevent us frofn making anything beyond rough
estimates on this basis. We have to count, normally, with an
extensive overlapping between the various organisations. The
oral phase, for instance, persists for months, after the anal-
sadistic organisation has come into being; anal-sadistic mani-
festations do not disappear with the beginning of the phallic
phase. The latency period is usually in existence for one or
two years before the tendencies of the first infantile period
fade into the background. It would, for instance, be erroneous
to conclude from a continuance of oral or anal forms of auto-
erotic gratification in the fourth or fifth years, that the child
has failed to reach the phallic level. It never happens that the
whole of the libido expresses itself in the manifestations of
the latest phase of development only; some part of it invariably
remains attached to earlier modes of expression. To ensure
normality it is sufficient if the bulk of the libido reaches the
organisation which is appropriate to the age of the child. The
manifestations of this level then predominate over the earlier
ones, though never as fully as the genital tendencies of adult
sex life predominate over the pregenital tendencies,

INDICATIONS FOR CHILD ANALYSIS 79

There are more reliable data on which an opinion about the
libidinal development of a child could, theoretically, be based:
namely the fantasies which accompany the child's masturba-
tory activities. But, practically, this is of little help for the
diagnosis. Such fantasies are always hidden, very frequently
unconscious, and only laid bare in the course of an analysis,
not in a consultation.

(b) The intactness of libidinal development

The libidinal normality of a child is, further, judged accord-
ing to the fate of the individual component instincts. We
would not expect any of the component instincts to be com-
pletely absent from the clinical picture (if the child is neither
organically nor mentally deficient) except as a sign of severe
neurotic disturbance.

But, again, individual variability is wide enough to warn
us to be careful in our conclusions. The component instincts
(including tendencies like exhibitionism, scoptophilia), or
rather their manifestations, are not visible to the same degree
in all children; nor does any individual child present us with
equally clear pictures of all the different libidinal tendencies.
Usually some of the component instincts are clearly in evidence,
others remain faint and shadowy. With some children we might
believe that cruelty, or exhibitionism, or gre'ed, have played
hardly any part in their lives ; with others these urges are un-
mistakable, and other instincts are only seen on closer observ-
ation. Individual differences of this nature are based on con-
stitutional factors, and are not due to neurotic interference ; but
they create points of special libidinal interests in the child's
life, so-called fixation-points, which play an important role in
later neurotic development.

(c) Neurotic interference with libidinal development*, the factor of

spontaneous recovery

A neurosis in an adult damages the intactness of the indi-
vidual's sex organisation ; an infantile neurosis interferes besides
this directly with the forward movement of the libido.

In the beginning stage of a neurotic conflict the libido, to
avoid anxiety which has arisen on a higher level of sex organis-

8O THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

'alien, flows backwards (regression), and attaches' itself once
more to earlier libidinal wishes (fixation point). The ego of
the child thus finds itself confronted with primitive desires
(oral, aggressive, anal), which it is not prepared to tolerate. It
defends itself against the instinctual danger with the help of
various mechanisms '(repression, reaction-formation, displace-
ments, etc.), but, if such defence is unsuccessful, neurotic
symptoms arise which represent the gratification of the wish,
distorted in its form by the action of the repressive forces.
While these symptoms persist, they are the central expression
of the child's libidinal life.

From the developmental point of view it is immaterial
whether such symptoms are a little more or a little less painful.
What counts is that with the onset of the neurotic disturbance
the libido has been arrested in its course. Instead of moving
on towards more adult levels, it has been forced backwards,
and important gains have thereby been undone. Qualities and
achievements which depend directly on the stage of libido
development are lost. The child who regresses to the oral
level, for instance, simultaneously reverts to the emotional
attitudes which are connected with it: it becomes once more
insatiable, exacting, impatient for wishfulfilment, "like a
baby". Regression from the phallic to the anal-sadistic level
destroys the hardly acquired attitudes of generosity, manliness
and protectiveness and substitutes for them the domineering
possessiveness which belongs to the earlier libidinal level.
But progress is made at the same time in other spheres which
are not influenced directly by the neurosis. The child grows
bigger and more clever, and its development becomes inharmon-
ious since this growing body and mind are tied to an instinctual
and emotional life which cannot keep pace with it. The need
for treatment seems urgent at this stage, not because the neurosis
is in itself so severe, but because the presence of the neurosis
hinders libido development.

On the other hand this impression of a serious hold-up is
frequently misleading. After a shorter or a longer stay, symp-
toms may suddenly lose importance; the fixation can dissolve
and the libido, freed from restrictions, resume its normal pro-
gressive flow. The child has, as the popular saying goes, "out-,

INDICATIONS FOR CHILD ANALYSIS 8 I

grown" its neurosis, and therapeutic help has become un-
necessary.

As analysts, who collect their evidence from adult cases,
we do not readily believe in the spontaneous cure of a neurosis,
and we view such appearances with distrust when they are
brought to our notice. We know that neuroses can, at best,
change their manifestations. Neurotic anxiety for instance
can disappear, but only to reappear later, centred round a
different object or topic. Changes in life circumstances can
alleviate a neurotic condition in various ways. Neurotic suffer-
ing can be exchanged for ordinary suffering; for instance the
real loss of an object through death can take the place of the
imagined loss of love from that object, and thus make a parti-
cular symptom unnecessary. A masochistic desire, which at
one time manifests itself in neurotic symptoms, can find satis-
faction in organic illness at another time. Inhibitions or
obsessional restrictions which cripple a patient's activity may
be given up when the same person is, for instance, in prison or
in a concentration camp, that is, lives under crippling and in-
hibiting circumstances. A neurosis can further be relieved
through separation from the love object on to which it has
transferred its central issues ; but such relief will be temporary,
and the neurosis will soon re-establish itself completely when
a new transference has taken place. Happenings of this kind,
though often described as temporary or permanent spontan-
eous cures, are merely slight fluctuations within the neurotic
arrangement itself.

On the basis of our theoretical knowledge,, there is little
reason to expect the neuroses of adults to clear up spontan-
eously. The neurotic symptom, as a compromise between two
opposing forces, can only alter when decisive changes take
place, either in the instinctive tendencies or in the ego and
super-ego of the individual. Neither kind of change is likely
to happen in the adult. The infantile wish, to which the patient
has regressed, will remain potent. The ego will keep its repres-
sive energy (unless a serious deteriorating process sets in).
Furthermore, the whole process is anchored in the uncon-
scious, and therefore not accessible to influence from conscious
levels,

82 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

This is where conditions in the case of an infantile neurosis
are, completely different. The child's libido organisation is, as
described before, in a fluid state., the libido moving on continu-
ously towards new positions. A component instinct which is
charged with libido in one phase, may be devoid of interest
at another. The child need not remain hopelessly tied to any
fixation-point to which it has been led back through regression.
If the fixation is not excessively strong, the libido has a good
chance of freeing itself again, carried forward by the next wave
of development. This possibility is greatest at times when the
biological urges are of especial strength, as they are at the onset
of the phallic phase (four-five years) and of puberty.

(It is a common error to believe that, due to the strengthening of
the ego, children become more neurotic in the latency period. On
the contrary, the latency period marks a definite decrease in infantile
neurosis. At that time the strength of the infantile sex wishes dies
down, partly for biological reasons, partly owing to the frustration
of the child's Oedipus wishes. This lessens the need for defence
against the instincts and alters the compromise-formations between
ego and id which lie at the root of symptom formation. Many infantile
neuroses therefore disappear at approximately that date, their spontan-
eous cure "being due to these quantitative changes.

Puberty is rightly regarded as a time when numerous neurotic
disturbances may be expected to appear. It is less well known that
puberty also removes certain neurotic symptoms which are typical
for the years preceding it This refers especially to the neurotic behav-
iour of boys who, all through early childhood and latency, fight against
repressed wishes of a passive feminine kind. Their behaviour is char-
acterised by anxiety, due to their repressed castration wishes, and by a
superficial and noisy aggressiveness which is a reaction against the
underlying passivity. Puberty brings a biological increase in genital
masculinity which, while it lasts, puts the anal, passive and feminine
tendencies out of action. This is a spontaneous cure in the real sense
of the word: the neurosis not merely changes its form, but the under-
lying unconscious forces themselves undergo alterations. It depends
on future developments whether the former constellation of instincts
will come to the fore again in aclult life; in this case the neurotic defence
against it will be re-instated.

There are other typical examples of infantile neuroses which dis-
appear almost invariably before adolescence: bed-wetting, and some

INDICATIONS FOR CHILD ANALYSIS 83

of the common eating disturbances. They also are swept away by the
libidinal changes before or in puberty. Certain disorders affecting
sexual potency, and certain" nervous disorders of the stomach may,
much later, appear in their stead, if 'the adult genital sex organisation
is not strong, enough to maintain itself.)

To sum up : the decision whether a child needs therapeutic
help or not can be based on the state of the libido development.
An infantile neurosis can be treated as a transitory disorder so
long as the libido organisation of the child remains fluid and
shows progressive tendencies. Infantile neuroses disappear
whenever the normal forward movement of the libido is strong
enough to undo neurotic regression and fixation. When the
libido constellations become rigid, stabilised, and monotonous
in their expressions the neurosis is in danger of remaining per-
manently. This means that treatment is indicated.

This view, that child-analysis should be used sparingly, in
cases where the hope for a spontaneous recovery is slight or
non-existent, is opposed to the opinion which many analysts
hold, that child-analysis might be used prophylactically, to
remove the pathogenic fixation-points.

3 . Neurotic Interference with Ego-Development

The threat which the occurrence of an infantile neurosis
constitutes for the libido development of the individual is so
blatant that it has not escaped notice. The same danger is less
obvious where the development of the ego is concerned. On
the contrary, there is a common belief that neurotic develop-
ment in children is coupled with an especially good, frequently
an especially early, blossoming of this side of the child's person-
ality. It is left an open question whether it is the infantile
neurosis which, as one of its results, overemphasizes the side
of the ego forces, or whether it is an early ripening of the
ego which predisposes the child for a severe infantile neurosis.

The following is an attempt to examine the questions whether
a childhood neurosis helps or harms the building up of the ego;
what the interactions are between the two processes ; and whether
the degree of harm done to the ego can serve as a further in-
dication for the therapeutic use of child-analysis.

84 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

('a) The quantitative factor in Ego-Development

A neurosis can affect the ego quantitatively, that is, in its
strength.

The term ego strength is not meant to denote an absolute
quantity of ego forces which are, in themselves, not measure-
able. It refers to the relative efficiency of the ego with regard
to the contents of the id (the instincts) and to the forces of the
environment with which the ego has to deal. This ego strength
varies repeatedly in the course of normal development. In
the beginning of life the instincts are of overwhelming strength
and the first crystallisations of an ego are completely under
their domination and at their service. The child's growing
awareness of the outside world, the beginnings of its ability to
retain and connect memory traces, to foresee events, to draw
conclusions from them, etc., are used exclusively for the purpose
of instinct gratification. The better the ego development of an
infant, the better are its chances to gratify its desires and to use
the outside world for the fulfilment of its wishes. This undis-
puted reign of the instincts does not last longer than early
infancy. As a result of its strong emotional ties to the parents,
the child soon begins to regard their wishes, which are fre-
quently in opposition to its own. To the degree in, which it is
able to identify with the parents who educate it, its ego develops
hostile attitudes towards its instincts and attempts to oppose
and manage them. Simultaneously it begins to correlate con-
flicting emotions and tendencies instead of giving alternate
expression to them as has happened so far. This means sup-
pressing on or the other side of them (love or hate, active or
passive desires, etc.), and creates new conflicts between ego
and id. But although all these efforts are made by the ego to
assert itself against the instincts, no real ego superiority is
established in the first period of childhood. The pull of wish-
fulfilment is still too strong, and the principle which governs
the child's life remains to a large extent the pleasure principle*
It is only the final frustration of the Oedipus wishes, with the
consequent fading out of the early libido organisations, which
chahges the situation decisively in favour of ego strength,
While the sex drives remain latent (latency period), the ego
assumes superiority, directs the actions of the child, establishes

INDICATIONS FOR CHILD ANALYSIS 85

the reality principle, and effects the first real adaptation to the
exigencies of the outside world. Ego and id have now reversed
their positions. But the new order is by no means permanent,
Ego superiority is overthrown again as soon as the first signs of
adolescence appear. Because of the biological increase in pre-
genital tendencies during pre-puberty, and genital tendencies
during puberty, the libidinal forces rise in strength. During
the "whole of adolescence ego forces and id forces struggle with
each other for the upper hand, a combat which is responsible
for many of the conflicting and abnormal manifestations of
that period. It is impossible to predict before adolescence is
over, whether the individual will emerge from this struggle
with a strong or with a weak ego, but this uncertainty is normal
and necessary. It is essential for the development of a rich and
vivid personality that this part of character formation (the
establishment of a definite proportion between id strength
and ego strength) should not be terminated too early. The
changing flow of libidinal development should, while it lasts,
find scope for at least transitory expression without being too
crippled by the dictates of a strong ego. On the other hand
every new gain in the ego achievements should contribute
something towards altering the balance between ego and id
and mark a further step in perfecting a sensible management
of the instincts. 1 The personality of the child will develop
so long as the relationship between ego and id remains fluid and
changeable.

The incidence of an infantile neurosis acts like a calcification
in the middle of a living organism. Every neurotic symptom
represents an attempt at establishing an artificial balance
between an instinctive wish and the repressive forces of the
ego, a balance which is rigid and, once established, not open to
correction. If symptoms multiply and the neurosis organises
itself into a coherent structure, the whole relationship between
ego and id becomes hopelessly paralysed.

Another and more direct manner in which infantile neuroses
reduce ego strength is due to the regression which occurs

1 A little girl of four and a half, when asked to behave and control herself
specially on a certain occasion in the absence of her nurse, answered sensibly,
"I think I can manage."

D

86 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

invariably at the beginning of symptom formation. Libidinal,
regression is always accompanied by a certain amount of ego
regression; ego strength is to a degree dependent on the phase
of libido development. The oral organisation of the libido,
for instance, always goes together with a special urgency of
wishes and impatience for wishful filment. That means,
practically speaking, that a child who regresses from the
genital to the oral level simultaneously regresses from ego
strength to ego weakness. Or, to put it differently, regression
from the genital to the oral level implies regression from the
reality principle to the pleasure principle.

The neurotic child may thus, at first glance, appear to possess
a strong ego. But this appearance is misleading. Its ego is
committed to a definite and not reversible attitude to an instinct,
in order to maintain the delicate balance which is necessary for
symptom formation. But its ego is in reality weaker than that
of a normal child since the id forces have gained a more or less
lasting victory in the disguise of symptom formation.

(b) The qualitative factor in ego-development

From the first months of life onward the ego develops from
a mere meeting point for dimly perceived stimuli into an
organised centre where impressions are received, sorted out,
recorded, interpreted, and action is taken on the strength of
them, (A separate part of the ego fulfils the task of supervising
thoughts and actions from a moral point of view [super-ego].)
The essential ego functions in this respect are: testing of inner
and outer reality; building up of memory; the synthetic function of
the ego; and ego control of motility. All through childhood a
ripening process is at work which, in the service of an increas-
ingly better knowledge of and adaptation to reality, aims at
perfecting these functions, at rendering them more and more
objective and independent of the emotions, until they can
become as accurate and reliable as any non-human mechanical
apparatus. In the last resort, an individual's efficiency in life
(under less civilised conditions his chance of survival) is deter-
mined by the perfection or imperfection of these ego functions.

But simultaneously with this maturing process another,
even more powerful, tendency is at work in the child. These

INDICATIONS FOR CHILD ANALYSIS 87

ego achievements are wholly acceptable to it so far as they
serve instinct gratification and provide some mastery over the
environment. But it soon becomes evident that this new way of
functioning brings at least an equal, if not an overwhelmingly
greater amount of pain, discomfort and anxiety. Each one of
the new functions has its disagreeable consequences. The
faithful testing and recording of outside reality reveals to" the
ego the existence of countless alarming possibilities ; the outer
world is. shown to b$ full of frustrations, disappointments,
threats* The testing of the child's own inner reality reveals
the existence of forbidden and dangerous tendencies which
offend the child's conception of itself and therefore cause
anxiety. The sorting out and interpreting of stimuli., as they
arrive, leads to drawing a sharp line of distinction between the
child's own self and the objects outside; before this faculty
had been developed, the infant had been able to feel itself as
one with the world around, to count as itself whatever was
pleasurable, and to ascribe to an "outside" what was dis-
pleasing. The development of the function of memory is equally
disturbing, since it aims at retaining memory traces irrespective
of their quality; the infant used to give preference to pleasant
memories and to reject the painful ones. The synthetic function
of the ego which aims at unifying and centralising all mental
processes, is opposed to the free and easy manner in which the
infant used to live out its most divergent emotions and instinc-
tive urges either simultaneously or alternately, as for instance
love its parents, and hate them, be a passive baby in need of
comfort from its mother at one moment, only to confront her
as an active male lover and protector the next moment; to
destroy possessions, and then immediately afterwards violently
to desire and to treasure them. Lastly, a strict ego control of
motility permanently deprives the instinctive forces in the id
of their former free expression.

Strictly objective functioning of this nature heightens the
feeling of tension and anxiety for the ego. On the one side the
libidinal forces in the id, represented by the component
instincts of infantile sexuality, are felt to clamour for satis-
faction. On the other, the adults in the outside world are per-
ceived to threaten punishment or loss.of love if the child should

88 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

indulge in forbidden sexual or aggressive wishes and actions.
From the side of the super-ego, i.e. from within, ..the ego is
flooded with feelings of guilt and self criticism whenever it
fails to live up to its own standards.

The weak and immature ego of the child fails to stand up
to the impact of these dangers. It consequently attempts to
undo its own achievements as fast as they are made. It tries
not to see outside reality as it is (Denmf}\ not to record and
make conscious the representatives of the inner urges as they
are sent up from the id (Repression}; it overlays unwelcome
urges with their opposites (Reaction-Formation} ; it substitutes
for painful facts pleasurable phantasies (escape into Fantasy-
Life}\ it attributes to others the qualities which it does not
like to see in itself (Projection} ; and it appropriates from them
what seems welcome (Introjection), etc.

Normally,, in every childhood, these methods are used in a
moderate degree to defend the ego against anxiety. A certain
retrograde movement in the development of the ego achieve-
ments is therefore the rule. It does not more than create a
certain amount of subjective and faulty functioning which is
usually overcome with the beginning of the latency period
when the position of the ego is strengthened and anxiety lessens.

But events shape themselves differently where acute neurotic
conflicts intervene either in the preoedipal phases or during
the Oedipus phase. In the face of excessive anxiety the ego
makes excessive and more lasting use of the defence mechan-
isms at its disposal. Therefore the harm done to the ego func-
tions becomes considerably greater and is of more permanent
importance.

Examples of the excessive use of the method of denial of outside
reality can be found when the child is confronted with the facts of
difference of the sexes, which give rise to penis envy and castration
anxiety. Under the pressure of these painful emotions the ego waives
reality testing^ pretends to see what is not there (for instance a penis
on the mother), or ignores what is in plain view. (A little girl., on
watching her new born brother's penis, said, with satisfaction, to her
sister: "He has a belly-button just like us," thus remarking on their
similarity instead of admitting the obvious difference between them.)
Denial makes still greater inroads on reality testing where the central

INDICATIONS FOR CHILD ANALYSIS 89

subject of observation of parental intercourse is concerned. Under
the influence of their oedipal jealousy children, will refuse to realise
that their parents have a sex life with each other, and will uphold this
denial in spite of all other advances in knowledge of biological facts,
of propagation among animals, and even of the facts of life where they
concern strangers. Evidence of such denial can be found in countless
fairy tales, myths, religious beliefs, etc. Under neurotic conditions it
frequently outlives the latency period, and adolescence and continues
into adult life. But even normally, so long as children avoid admitting
reality in this all important respect, they are not free to use their full
intelligence for becoming acquainted with outside reality. (An adult
neurotic, by profession a medical man, began his analytic cure with
the following words: "My parents never had anything to do with each
other," Since he was a child in an interminable row of brothers and
sisters, there was evidently no truth in his statement. But it contained
the key to his neurotic and bizarre behaviour which, to a degree,
made his dealings with the real world unpredictable and unreliable.)

Examples of excessive use of the method of repression are, by now,
common knowledge. Repression occurs invariably when a young
child finds itself faced with the intolerable frustration of the component
instincts of his early instinctive life. It is easier for the child to stand
the clamouring for satisfaction which comes from the id when the
representatives of the instincts are refused admittance into conscious-
ness, i.e. are repressed. Since all instinctive manifestations are inter-
related, such repression draws ever widening circles until ego and id
become entirely estranged from each other. What the neurotic child
knows about its own inner life is frequently negligible, at best it is
scanty and faulty. Awareness of inner reality cannot be upheld under
these conditions.

The most instructive instance of neurotic defence doing harm, to an
ego function is the complete obliteration of childhood memories due
to repression. To uphold belief in the asexuality of the parents, or to
blot out coitus observations, or scenes of seduction, etc., the memory
traces of whole periods of life are removed from consciousness, thus
damaging the objectivity of the function of memory, and disrupting
and disconnecting the individual's relationship to his own past. Norm-
ally all children remove the traces of their earliest years in this manner,
to spare themselves the memory of their primitively aggressive, and
crudely sexual infantile reactions; but this infantile amnesia should
not cover more than the first years of life. (A neurotic young girl was
able to remember most of her past childhood, with the exception of
two years during the latency period, the memory traces of which were

90 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

completely absent. Her analysis revealed that during this period her
widowed mother had been "unfaithful*' to her dead father, a fact which
the child was trying to ignore.)

Excessive use of projection is usually made by neurotic children
when dealing with their hostile feelings against father or mother.
They either ascribe these tendencies to the parents themselves, or to
another child, or to an animal, etc. When used in a normal degree
this defence method is an important transitory help in the development
of the personality. Used excessively it once more blurs the newly-made
distinction between the child itself and the world outside. (A child of
two and a half was subject to violent tempers directed against her
mother substitute, would shout, throw things at her, etc. When .she
began to make attempts to overcome these tantrums, she suddenly
got hold of the push horse of the nursery, rushed it against the nurse,
shouting: "Naughty Jane, jiji bite you now." When the nurse said,
"Oh, no, the horse will not bite me, it is not cross with me, but you
are," the child laughed and said: "No, me not cross, only jiji.".
Similarly children ascribe their bad feelings to the "big bad wolf", or
some other outside agency, with the result that they themselves can
feel all "good" and loving.

Another defence method for dealing with the negative side of the
child's ambivalence against the parents is the splitting of the personality^
with the resulting damage for the synthetic function of the ego. For
certain periods many children go so far as inventing special names
for their "good" and their "bad" selves, though normally they retain
the knowledge that both, the good and the bad child are themselves,
with a vague feeling of responsibility remaining for both. In an out-
standing case of this kind, a girl of six used to refer to her bad side con-
sistently as "the devil" and had ceased to feel any conscious respon-
sibility for the devil's thoughts or actions.

One of the most important advances in ego development during
early childhood is the control of actions by the ego itself. This is with-
drawn when too many actions become invested with symbolical
sexual or "aggressive significance. The ego then tries first to inhibit
them and if unsuccessful, withdraws from certain forms of activity
altogether, leaving the control of motility in these respects to the forces
of the id. The child then presents a picture, partly of inhibitions , partly
of unreliable, unpredictable, functioning, which is not adapted to
reality. (A little girl of three was hardly able to use her hands for any
sensible occupation. She used to stretch them out in front of her, lifted
up as if warding off actions, her fingers spread wide apart. In this
manner she kept herself from committing the aggressions against her

INDICATIONS FOR CHILD ANALYSIS v 91

little companions with which her mind was constantly occupied in
fantasy, Many boys arc greatly disturbed in their urinary function
by guilt feelings which arise when they have to touch their genital.
They withdraw from this function because for them it implies the wish
to masturbate. A boy of eight was unable to use a knife at table, since
he had the fantasy of cutting his mother with it; but withdrawing
from this action was of little help since his aggressive wishes dominated
other activities., for instance when he was holding a stick, etc., which
then from sensible actions suddenly changed into passionate attacks on
his mother, etc.

The common escape into fantasy which is of the greatest help to
every child, is used excessively under the pressure of neurotic conflicts,
and can then become the basis for a complete withdrawal and estrange-
ment from the real world and its demands.

*t

This interference with the ego functions is of greater im-
portance in childhood than it will be, under otherwise similar
conditions, in the adult neurosis. It occurs while the ripening
process of the ego is still in action. The function which is
most directly attacked by the infantile neurosis will, at least
temporarily, be kept back from further development, while
the other ego achievements continue to mature. Accordingly
ego development will become onesided and unharmonious.

The particular defence mechanism which will be most in
use, and the particular ego damage which will occur as its
consequence, depends on the type of infantile neurosis con-
cerned. In the various forms of hysterical neurosis anxiety is
warded off with the predominant help of repression. This
may account for the fact that children of the hysterical type,
frequently possess a faulty and unreliable memory with conse-
quent difficulties in studying; damage to the function of
memory has spread further than the emotionally dangerous
memories with which the ego tried to interfere. Obsessional
children usually have an excellent and undisturbed memory;
but, owing to the excessive ego interference with . the free
expression of their anal-sadistic tendencies, they are estranged
from their own emotions, and are considered cold and un-
responsive, even where other than these primitive aggressive-
sexual manifestations are concerned. Phobic children deal
with their anxieties by withdrawal from their danger-points.

92 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

They tend to withdraw from many forms of activity altogether
and give up motility, far beyond the original range of neurotic
danger. As a consequence they frequently become altogether
retiring and clumsy in their actions, with passionate and un-
predictable outbreaks whenever the motility is governed by
the id forces instead of the ego.

With this point of view in mind, it may be possible to assess
the seriousness of an infantile neurosis, and with it the need
for treatment,, in an indirect way, through the harm done to
the ego functions by the extensive use of one or several of the
neurotic defence mechanisms. There is no reason for alarm
or interference when one or another of the ego achievements
are reduced, or retarded in their development, or temporarily
put out of action. This is a normal and inevitable occurrence.
But such retardations may become lasting; several, or all, of
the important ego functions may be severely attacked at the
same time. If a child shows a faulty knowledge of the outer
world, far below the level of its intelligence, if it is seriously
estranged from its own emotions; with blank spaces in the
remembrance of its own past, beyond the usual range of infan-
tile- amnesia; with a split in its personality; and with motility
out of ego control; then there can be little doubt that the
neurosis is severe, and that it is high time to take therapeutic
action.

CONCLUSION

In the foregoing pages an attempt is made to find indications
for the therapeutic use of child analysis not so much in the
neurotic manifestations themselves, as in the bearing of these
manifestations on the ripening processes within the individual
child. Emphasis is shifted thereby from the purely clinical
aspects of a case to the developmental aspect.

When diagnosing cases from this point of view, the child
analyst, or child psychiatrist, has to be as intimately familiar
with the normal sequence of child development as he is familiar
with the neurotic or psychotic disturbances of it. He is, really^
faced with the task of judging the normality of the develop-
mental process itself.

INDICATIONS FOR CHILD ANALYSIS 03-

It is an open question how much help diagnosis of this kind
can receive from academic psychology. The various mental
tests, so far devised, assess circumscribed aspects of ego develop-
ment; they are nearly indispensable in cases where a differential
diagnosis between mental defectiveness and defective aware-
ness of reality through excessive denial has to be made. The
Rohrschach test goes further into inquiring into the state of
libido development and its disturbances. Other tests try to
disclose the phantasy life of the individual. It is to be expected
that in time further mechanised methods will be devised to-
cover an increasingly wider range of the factors on which a
satisfactory diagnosis of infantile neuroses can be based.

At present our analytical knowledge about the develop-
mental processes on the libido as well as on the ego side is still
very incomplete in itself. Besides, too little is known about the
interactions between them, beyond the fact that a precocious
ego is especially intolerant when coupled with the primitive
pregenital component instincts. We are only slowly learning to
distinguish the various characteristics which mark a neurotic
disturbance as either transitory or as permanent, although this
distinction is of extreme importance for our diagnoses. Not
enough is known about the relation between the development
of the purely intellectual factors and the other important func-
tions of the ego, etc.

Until these gaps are filled by more clinical data from the
psycho-analytical investigation of single children, it will be
necessary not to confine examinations to short-cuts of any kind,
helpful as they may be in furnishing additional data, but to
adhere to the former, lengthy, laborious, and groping methods
of individual approach.

BIBLIOGRAPHY

Abbreviations

Psa.Q. The Psychoanalytic Quarterly^ New York.

J.Psa. International Journal of Psychoanalysis.

Z.Psff. Internationale Zeitschrift fuer Psychoanalyse.

Z.pstf.P. Zeitschrift fuer psychoanalytische Paedagogtk.
j4. J. Orthops. American Journal of Orthopsychiatry.

Psa.R. Psychoanalytic Review.

s (i) Anna Freud, "Einfuehrung in die Technik der Kinderanalyse",
Internat.^Psychoanalyt. Verlag, Vienna, 1927.

( 2 ) - , "On the Theory of the Analysis of Children", J.Psa.,

X, 1929.

(3) "The Psychoanalytic Study of the Child", an Annual Vol., I, New

York, and Imago Publ. Co., London, 1946.

(4) Anna Freud, "Introduction to the Technique of Child- Analysis",

Nervous and Mental Disease Monograph Series No, 48, 1929.

(5) Melanie Klein, "The Psycho- Analysis of Children", The Internat.

Psycho- Analytical Library, No. 22, 1932.

(6) "Symposion on Child-Analysis", J.Psa. 9 VIII, 1927.

(7) Bcrta Bornstein, "Zur Psychogenese der Pseudodebilitaet", Z.Psa.,

XVI, 1930.

gj - 5 "Bezichung zwischen Sexual- und Intellektentwick-
lung", Z.psa.P., IV, 1930.

7 "Enuresis und Kleptomanie als passageres Symptom",

Z.psa.P., VIII, 1934-

5 "Phobia in a Two-and-a-half year-old Child", Psa.Q.,

IV, 1935-
( u ) - 5 "Leugnung durch die Phantasie", Z.psa.P. y X, 1936.

(12) StefF Bornstein, "Eine Technik der Kinderanalyse bei Kindern

mit Lernhemmungen", Z.psa.P., VIII, 1934.

( 13 ) - , "A Child Analysis", Psa.Q., IV, 1935.

(14) Dorothy Burlingham, "Child Analysis and the Mother", Psa.Q.,

IV, 1935.

(15) _ - ^ "Phantasie und Wirklichkeit in einer Kinderanalyse",

Z.Psa.> XXIV, 1939.

96 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN

(16) Edith Buxbaum, "Exhibitionistic Onanism in a Ten-year-old
P.MV, 1935.
5 "The Role of Detective Stones in a Child Analysis 77 ,

(18) Margaret E. Fries, "Play Technique in the Analysis of Young

Children 7 ', Psa.R., XXIV, 1932.

(19) Elizabeth R. Gelcerd, "The Analysis of a Case of Compulsive

Masturbation in a Child", Psa.Q., XII, 1943.

(20) Wilhclm Hoffer, "Bericht ucber die Einleitung eincr Kinder-

analyse", Z.psa.P., IX, 1935.

(21) Anny Katan-Angel, "From the Analysis of a Bed- Wetter", Ps&.Q.,

IV, 1935.^

(22) Marianne Kris, "Kin MaerchenstofF in einer Kindcnmalyse' 1 ,

Z.psa.P.,VI, 1932.

(23) Estelle Levy, "Psychoanalytic Treatment of a Child with a Stealing

Compulsion", Jt.J.Orthops., IV, 1934.

(24) Kata Levy, "Vom Bettnaessen des Kindes", Z.psa.P., VIII, 1934.

(25) Anna Maenchen, "Denkheminung und Aggression", Z.psa.P.,

X, 1936.

(26) Editha Sterha, u An Abnormal Child 77 , Psa.Q.> V, 1936.

27) - , "Excerpt from the Analysis of a Dog Phobia 71 , Pw.Q.,

IV, 1935- ...... '

(28) - , "Aus der Analyse eines Zweijaehrigen", Z.psa.P. 9

VIII, J934-

(29) - , "Ein Fall von Esstoerung", Z.psa.P.^ IX, 1935.

(30) Jenny Waeldcr, "Analyse eines Falles von Pavor Nocturnus 11 .
' Z.p M .P., IX, 1935-

(31) August Aichhorn, "Wayward Youth 1 ', Putnam, London^ 1936,
(22) - , "Er/jehungsberatung", Z.psa.P., VI, 1932,

j "Zur Technik der Er/.ielumgsberatung", Z.psn.P.,
X,i 9 36. _

, "The Juvenile Court; Is it a Solution?" Revue Inter-
nationale de 1 'Enfant, Vol. IX, No. 51, March, 1930.
(35) Alice Balint, "Die Psychoanalyse des Kinderzimmers", Z.psa.P,,
VI, 1932.

, "Versagen und Gewaehren in der Er/jehung", Z.psa.P. 9
X, 1936.

3 u Die Grundlagen unseres Erxiehungssystems", Z.psa.P.,

_X, 1937.

(38) Th. Bergmann, "Versuch der Behebung einer Eraichungs-

schwierigkeit", Z.psa.P., XI, 1937.

(39) Siegfried Bernfeld, "Kinderheim Baumgarten", Juedischer Verlag,

Berlin, 1922.

(40) - , "Sisyphos oder die Grenzen der Erziehung", Internat.
Psyehoanalyt. Verlag, Vienna, 1925.

BIBLIOGRAPHY 97

at.

? "Psychology of the Infant", Kegan Paul, London,
1929,

(42) ---------- -, "Ucber die einfachc maennliche Pubertaet", Z.psa.P.,

IX, 1935.

(43) Stcff Bornstein, u Missvcrstacndnisse in der psychoanalytischen

Paedugogik", Z.psa.P,, XI, 1937.

(44) Edith Braim, "Eine Kinderfreundschaft. Beobachtung aus einem

Kindergarten", Z.psa.P., X, 1936.

(45) Marie H. Briehl, "Die Rollc dcs Maerchens in der Kleinkinder-

eraelumg", Z.psa.P., XI, 1937.

(46) Dorothy Burlingham, u Probleme des psychoanalytischen Erzie-

hers", Z.psa.P., XI, 1937.

(47) Edith Buxbaum, "Massenpsychologic und Schule", Z.psa.P., X,

1936.

(48) H. Fischer, u Schnsucht und Selbstbefriedigung", Z,ps*.P., VII,

933-

(49) H, Fischer and Lilie Peller, u Eingewoehnungsschwierigkeiten im

Kindergarten", Z.psa.P., VIII, 1934.

(50) Anna Freud, "Introduction to Psycho- Analysis for Teachers"

George Allen & Unwin, Ltd., London, 1931.

(51) Herta Fuchs, 'Tsychoanalytische Heilpaedagogik im Kinder-

garten", Z.psa.P., VI, 1932.

(52)' - , "Probleme der heilpaedagogischen Kindergarten-
gruppen'"', Z.psa.P., VII, 1933.

(53) ^ ri ^ Homburger, "Psychoanalysis and the Future of Education",

PM.Q., IV, 1935.

(54) Alice Landau, "Angsterlebnisse eines Dreijaehrigen", Z.psa.P.,

X, ^936.

(55) Emmi Minor-Zaruba, "Die fuenfjaehrige Nora im Kinder-

garten", Z.psa.P.j XI, 1937.

(56) K. Pensimus, "A Rejected Child", Psa.Q., IV, 1935.
(5 7 j - ? "Folgen der Entrechtung", Z.psa.P., VII, 1933.

(58) Emma Plank-Spira, a Eine Einschlafstoerung aus Todesangst",

Z.psa.P.,Xl, 1937.

(59) Ann! Poertl, "Profound Disturbances in the Nutritional and

Excretory Habits of a Four and One-half Year Old Boy: Their
Analytic Treatment in a School Setting", Psa.Q., IV, 1935.

9 "Verspaetete Reinlichkeitsgewoehnung", Z.psa.P.,

VII, 1933.
(61) Fritz Redl, a Zum Begriff der 'Lernstoerung 7 ", Z.psa.P., VIII,

1934,

98 THE PSYCHO-ANALYTICAL TREATMENT OF CHILDREN"

(62) Fritz Redl, "Gedanken ueber die Wirkung ciner Phimose-
operation", Z.psa.P,, VIII, 1934.

, "Der Mechanismus der Strafwirkung", Z.psa.P., IX,

(64) M. Schmaus, "Bravhcit und neurotische Hemmung", Z.psa.P.,,

vn, 1933-

(65) - , "Esstoerung und Verstimmung", Z.psa.P., X, 1936.

(66) Editha Sterba, "Verbot und AuiFordcrung", Z.psa.P., VIII, 1934.

(67) - 5 "Zwei Artcn der Abwehr", Z.psa.P., X, 1936.

(68) - 3 "Schulc und Erziehungsbcratung", Z.psa.P.> X, 1936.

(69) Dorothy Burlingham and Anna Freud, a Young Children in War-
, Time", George Allen & Unwin, Ltd., for the New Era, London,

1942.

(70) - ! - , "Infants without Families", George Allen & Unwin,

Ltd., London, 1943.

(71) Anna Freud, "The Ego and the Mechanisms of Defence", The

International Psycho- Analytical Library, No. 30, London.
1937, original German edition, 1936.

(72) Berta Bornstein, "Clinical Notes on Child Analysis", The Psycho-

Analytic Study of the Child, Vol. I, New York, 1945, London.
1946.

(73) N. W. Wulff, "Phobic bei einem andcrthalbjaehrigen Kinde".

Z.Psa., XIII, 1927.

(74) S. Freud, "Analysis of a Phobia in a Five-Year-Old Boy",

Collected Papers., Ill, Hogarth Press, London.

? "Three Contributions to the Theory of Sex", Nervous
and Mental Disease Monograph Series 7.

CHISW1CK PRESS

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